Application Of Superb Microvascular Imaging In Evaluation On The Diagnosis And Treatment Of Rheumatoid Arthritis

ObjectiveThe hand and wrist joints of patients with rheumatoid arthritis were examined by superb microvascular imaging technology,and the hypertrophic synovium of the joint,the blood flow signal in the synovium and the ulnar wrist extensor tendon sheath lesions were observed.To explore the value of microvascular imaging in the diagnosis of rheumatoid arthritis in patients with ulnar wrist extensor tenosynovitis,and to evaluate the value of superb microvascular imaging in the treatment of rheumatoid arthritis.MethodsForty rheumatoid arthritis in activity and twenty volunteers were selected as experiment group and control group respectively.Recording the age,sex of the two groups,and the course of the disease,swollen joint counts,tender joint counts,erythrocyte sedimentation rate,C-reactive protein,then calculate the disease activity score DAS28 of rheumatoid arthritis patients.Ultrasound was used to examine proximal interphalangeal joints,metacarpophalangeal joints and wrist joints.Power Doppler imaging and superb microvascular imaging were used to evaluate the blood flow signals in the tendon sheath of the ulnar extensor wrist of the bilateral wrist in patients with rheumatoid arthritis.Grayscale ultrasound was used to observe the presence of hypertrophic synovium and bone involvement,and superb microvascular imaging was used to observe the presence of blood flow signals in the synovial membrane,and the synovial hyperplasia score,superb microvascular imaging score and bone erosion score of the hand and wrist joints were calculated.After three months of treatment,thirty rheumatoid arthritis patients finished the visit.And recording the swollen joint counts,tender joint counts,erythrocyte sedimentation rate,C-reactive protein,then calculate the disease activity score DAS28,synovial hyperplasia score,bone erosion score and superb microvascular imaging score on wrists,metacarpophalangeal joints and proximal interphalangeal joints again.Statistical methods were used to analyze the difference of the blood flow signal display rate and blood flow grade between power Doppler imaging and superb microvascular imaging in the tendon sheath of the ulnar extensor wrist of the bilateral wrist in patients with rheumatoid arthritis.Also the differences of synovial hyperplasia scores,bone erosion score,superb microvascular imaging score and clinical characteristics before and after treatment and their correlations were analyzed.Results1.In forty active rheumatoid arthritis,there were eighty ulnar extensor muscles.The detection rate of blood flow in superb microvascular imaging tender sheath is higher than the detection rate of blood flow in power Doppler imaging tender sheath(56.3% vs 36.3%,P<0.05).2.The blood flow signal grade in the tender sheath of superb microvascular imaging was higher than that of power Doppler imaging(P<0.05).3.The blood flow signal grade in the tender sheath of superb microvascular imaging was positively correlated with 28 joint disease activity score,C-reactive protein(P < 0.05).4.The 28 joints disease activity score(DAS28),health assessment questionnaire,erythrocyte sedimentation rate,C-reactive protein(CRP),tender joint count,swollen joint count,visual analog scale,hypertrophic synovium score,SMI score were lower after treatment(P<0.05),the changes of bone erosion scores before and after treatment were not statistically significant(P> 0.05).5.Synovial hyperplasia scores of patients with rheumatoid arthritis before and after treatment were positively correlated with 28 joint disease activity score,c-reactive protein(P < 0.05).Before and after treatment,the signal score of the synovial blood flow by the superb microvascular imaging was positively correlated with 28 joint disease activity score,C-reactive protein and health questionnaire assessment(P < 0.05).Conclusion1.Superb microvascular imaging can improve the display rate of blood flow signal in the ulnar wrist extensor tendon sheath of patients with active rheumatoid arthritis,and provide important reference value for early diagnosis of patients with rheumatoid arthritis.2.Superb microvascular imaging can provide important reference value for the evaluation of the efficacy of patients with moderate and severe active rheumatoid arthritis.