The value of contrast-enhanced color Doppler ultrasound in the detection of vascularization of finger joints in patients with rheumatoid arthritis
The value of contrast-enhanced color Doppler ultrasound in the detection of vascularization of finger joints in patients with rheumatoid arthritis
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DOI：
10.1002/art.10136
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发表时间：
2002-03-01
影响因子：
--
通讯作者：
ZurNedden, D
中科院分区：
文献类型：
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作者：
Klauser, A;Frauscher, F;ZurNedden, D
目标。目的探讨彩色多普勒超声(CDUS)在评价类风湿关节炎(RA)患者手指关节内血运重建中的应用价值。对46例类风湿关节炎患者的198个手指关节和10名健康志愿者的80个手指关节进行了检查。临床炎症活动度不同的关节分为活动期、中度活动期或非活动期。彩色多普勒超声采用高频多维线阵探头。以微泡为基础的超声(US)造影剂(德国柏林先灵，Levovist)静脉输注。根据平扫和增强后的CDUS图像对多普勒结果进行分级。无论是平扫还是增强CDU，健康关节均未见关节内血管生成。平扫CDUS发现83个不活动关节中有7个(8%)，60个中度活动关节中有31个(52%)，55个活动关节中有32个(58%)。CDUS增强扫描发现在83个非活动期RA关节中41个(49%)，在60个中度活动期RA中59个(98%)，在所有55个活动期RA关节中。微泡为基础的超声造影剂(P<；0.001)改善了关节内血管形成的检测。CDUS增强扫描显示非活动期RA关节与活动期RA关节(P<；0.001)、非活动期RA关节与中度活动期RA关节(P<；0.001)、中度活动期RA关节与活动期RA关节(P<；0.001)的关节内血管生成存在差异。微泡超声造影剂的使用显著改善了RA患者手指关节内血管形成的检测。这项技术似乎是评估疾病活动性的一个有用的辅助工具。
Objective. A prospective study was performed to assess the usefulness of contrast-enhanced color Doppler ultrasound (CDUS) in the evaluation of intraarticular vascularization of finger joints in patients with rheumatoid arthritis (RA).Methods. We investigated 198 finger joints in 46 patients with RA, and 80 finger joints in 10 healthy volunteers. Joints with varying levels of clinical activity of inflammation were classified as being active, moderately active, or inactive. CDUS was performed with a high-frequency multi-D linear array transducer. A microbubble-based ultrasound (US) contrast agent (Levovist; Schering, Berlin, Germany) was intravenously infused. Doppler findings were rated on the basis of both unenhanced and contrast-enhanced CDUS images.Results. Healthy joints showed no intraarticular vascularization on either unenhanced or contrast-enhanced CDUS. Unenhanced CDUS detected intraarticular vascularization in 7 (8%) of 83 inactive joints, in 31 (52%) of 60 moderately active joints, and in 32 (58%) of 55 active joints. Contrast-enhanced CDUS detected intraarticular vascularization in 41 (49%) of 83 joints with inactive RA, in 59 (98%) of 60 joints with moderately active RA, and in all 55 joints with active RA. Detection of intraarticular vascularization was improved by administration of the microbubble-based US contrast agent (P < 0.001). Contrast-enhanced CDUS demonstrated differences in intraarticular vascularization between joints with inactive RA and those with active RA (P < 0.001), between joints with inactive RA and those with moderately active RA (P < 0.001), and between joints with moderately active RA and those with active RA (P < 0.001).Conclusion. The use of a microbubble-based US contrast agent significantly improved the detection of intraarticular vascularization in the finger joints of patients with RA. This technique seems to be a useful adjunct in the assessment of disease activity.