Clinical evaluation and power Doppler sonography in rheumatoid arthritis: Evidence for ongoing synovial inflammation in clinical remission
Clinical evaluation and power Doppler sonography in rheumatoid arthritis: Evidence for ongoing synovial inflammation in clinical remission
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DOI：
10.1097/smj.0b013e318164e16a
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发表时间：
2008-03-01
影响因子：
1.1
通讯作者：
Ardicoglu, Ozge
中科院分区：
文献类型：
--
作者：
Ozgocmen, Salih;Ozdemir, Huseyin;Ardicoglu, Ozge
目的：本研究提出了评估功率多普勒超声检查和频谱多普勒分析的手关节与临床和实验室参数之间的关系，在类风湿arthritis.Methods：患者接受疾病修饰抗风湿药物或生物制剂（英夫利西单抗）进行了联合检查，并进行了评估健康评估问卷，Duruoz的手指数，手功能测试。使用美国流变学学会和疾病活动性评分28联合（DAS 28）标准对所有患者进行疾病活动性分类。对10个掌指关节和4个腕关节（尺腕关节和桡腕关节）进行能量多普勒和频谱多普勒检查。对滑膜中的血流信号进行半定量分级。计算每例患者的累积血流信号评分（CFS）和平均阻力指数（RI）。结果：活动性疾病患者的CFS显著高于非活动性疾病患者，但平均PI相似。健康评估问卷、Duruoz手指数、Larsen和DAS 28评分与CFS显著相关，而血沉和C反应蛋白评分与CFS无关。平均RI与临床或实验室参数无关。根据美国流变学学会或DAS 28标准的临床缓解的患者中，大多数有持续的滑膜炎症的功率多普勒超声（58%和62%，分别）。结论：功率多普勒检查类风湿性手关节是一种实用的方法来估计滑膜炎症。通过将影像学技术与临床和实验室检查相结合来修改目前的缓解标准是可以想象的。这些结果强调了更复杂的研究的必要性，评估长期多普勒变化和临床参数之间的一致性。
Objective: This study proposed to assess the relationship between power Doppler ultrasound examination and spectral Doppler analysis of hand joints with clinical and laboratory parameters in rheumatoid arthritis.Methods: Patients receiving disease-modifying antirheumatic drugs or biologics (infliximab) underwent joint examination and were assessed by a Health Assessment Questionnaire, Duruoz's Hand Index, and Hand Function Test. All were categorized for disease activity using the American College of Rheumatology and disease activity score 28-joint (DAS28) criteria. Ten metacarpophalangeal joints and 4 wrist joints (ulnar-carpal and radiocarpal joints) in each patient were examined by power Doppler and spectral Doppler. Flow signal in the synovium was semiquantitatively graded. A cumulative flow signal score (CFS) and mean resistive index (RI) was calculated in each patient.Results: Patients with active disease had significantly higher CFS compared with patients with inactive disease, but the mean PI was similar. Health Assessment Questionnaire, Duruoz's Hand Index, Larsen, and DAS28 scores correlated significantly with CFS, but the erythrocyte sedimentation rate and C-reactive protein scores did not. Mean RI did not correlate with clinical or laboratory parameters. A majority of patients who were in clinical remission according to American College of Rheumatology or DAS28 criteria had ongoing synovial inflammation on power Doppler ultrasound (58% and 62%, respectively).Conclusion: Power Doppler examination of rheumatoid hand joints is a practical method to estimate synovial inflammation. A modification of current remission criteria by combining imaging techniques with clinical and laboratory examination may be conceivable. These results underscore the necessity of more sophisticated research, assessing the agreement between long-term Doppler changes and clinical parameters.