Application Of Superb Microvascular Imaging In Rheum Atoid Arthritis Synovial

Objective:1.To compare the display performance of color doppler flow i maging(CDFI),power doppler ultrasound(PDUS)and superb micro vascular imaging(SMI)on the synovial blood flow signals of rheu matoid arthritis knee joint.2.Superb microvascular imaging(SMI)synovial blood flow gr ading was compared with pathological synovial vascular grading in order to explore the application value of SMI technique in the syno vial vasospasm of knee joint.Methods:A total of forty-one patients with rheumatoid arthritis(RA)wh o underwent total knee arthroplasty(TKA)from March 2016 to Au gust 2018 in our department of orthopedics were enrolled.There w ere 3 males and 38 females,aged 40-75 years old,with an average of(49±6.3)years.The course of disease was 6 years to 30 years,with an average of(17±2.3).Another 10 healthy volunteers were s elected as the control group,5 males and 5 females,aged 38-70 y ears,mean(45±3.6)years old.Informed consent was obtained fro m all subjects.The blood flow signals of the supracondylar sac of the knee jo int were performed by CDFI,PDUS and SMI,respectively.Firstly,after total knee arthroplasty,the pathology of 49 knee sacral sac sy novial membranes was taken.Secondly,10 healthy volunteers were selected as the control group,and ultrasound examination was perfo rmed on 20 normal knee joint capsules.The knee joint was fully e xposed during the ultrasound examination,using an Aplio500 ultras ound system with a 14 MHz high frequency probe.After the para meters of the instrument were adjusted,and the blood flow signals of the synovial membrane of the knee joint were examined by thre e kinds of ultrasonic examination methods respectively.The synovia l part of the mark was checked after the end of the examination.T he knee joint synovial specimen at the marker was collected during total knee arthroplasty.Ultrasound images and pathological images o f the synovium were observed and recorded,then classified accordi ng to the corresponding criteria.Comparing the results of three diff erent ultrasound examination methods,and analyze the consistency of SMI classification and pathological grading.Using SPSS21.0 statistical software,the blood flow grading res ults of the three ultrasonic examination methods were compared wit h the Kruskal-Wallis H test;the three ultrasonic examination metho ds used the ROC curve for the evaluation of the pros and cons of the synovial blood flow signal display performance.The consistency of SMI grade and pathological grade was tested by Kappa.Results:1、Forty-one patients underwent total knee arthroplasty with 49knee joints.The results of the three ultrasound examination methods were statistically significant(H_C=11.84,P<0.05).The area under th e ROC curve of SMI,PDUS and CDFI was 1.000,0.990,0.969.S MI had the best diagnostic efficiency for synovial blood flow signal s,followed by PDUS and CDFI.2、The consistency of SMI grade and synovial pathological gra de was high(Kappa=0.639,P<0.05).Conclusion:1、Compared with CDFI and PDUS,SMI has a higher display performance on RA knee synovial blood flow signals.2、The consistency of SMI classification and pathological gradi ng is high.SMI technology can provide certain reference value for the evaluation of RA disease.