摘要
目的比较超微血管成像技术(SMI)与能量多普勒成像(PDI)和B型超声对非急性发作期痛风患者的诊断性能。方法收集2021年11月-2022年9月就诊于保定市第一中心医院门诊及住院的非急性发作期的痛风患者43例,分别应用B型超声、PDI及SMI检测痛风关节,使用Szkudlarek四级半定量评分系统对滑膜厚度及滑膜血流情况进行评估,比较3种方法对滑膜炎症改变的检出率;对SMI滑膜血流分级评估为1级及以上的关节,应用频谱多普勒(PW)在血流信号显示良好的区域测量滑膜血管阻力指数(RI),分析SMI血流分级与RI的相关性。结果不同SMI血流分级的患者年龄、BMI、尿酸水平、红细胞沉降率(ESR)及C反应蛋白(CRP)比较,差异均无统计学意义(P>0.05);SMI对滑膜炎症改变的检出率高于PDI和B型超声,差异有统计学意义(P<0.05);SMI较PDI可检测到更多的血流信号,差异有统计学意义(P<0.05);相关性分析显示,SMI滑膜血流分级与RI呈负相关(r=-0.520,P=0.000)。结论SMI在检测滑膜血流信号方面优于PDI,对滑膜血管有较好的检出能力,能够提高早期诊断痛风患者滑膜炎症的敏感性,可为患者病情的监测提供影像学证据。
Objective To compare the diagnostic performance of superb microvascular imaging(SMI),power Doppler imaging(PDI)and B-mode ultrasound in patients with non-acute gout.Methods From November 2021 to September 2022,43 patients with gout in non-acute attack stage who were admitted to the outpatient and inpatient departments of Baoding No.1 Central Hospital were collected.B-mode ultrasound,PDI and SMI were used to detect gout joints,and Szkudlarek four-level semi-quantitative scoring system was used to evaluate synovial thickness and synovial blood flow.The detection rates of synovial inflammation changes by the three methods were compared.The synovial vascular resistance index(RI)was measured by spectral Doppler(PW)in the area with good blood flow signal,and the correlation between SMI blood flow grade and RI was analyzed.Results There were no significant differences in age,BMI,uric acid level,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)among patients with different SMI blood flow grades(P>0.05).The detection rate of synovial inflammatory changes by SMI was higher than that by PDI and B-mode ultrasound,and the difference was statistically significant(P<0.05).SMI could detect more blood flow signals than PDI,and the difference was statistically significant(P<0.05).Correlation analysis showed that SMI synovial blood flow grade was negatively correlated with RI(r=-0.520,P=0.000).Conclusion SMI is superior to PDI in detecting synovial blood flow signals,and has a good detection ability for synovial blood vessels.Meanwhile,it can improve the sensitivity of early diagnosis of synovitis in gout patients,and provide imaging evidence for the monitoring of patients’condition.
作者
李喜艳
李林泽
张涛
LI Xi-yan;LI Lin-ze;ZHANG Tao(Graduate School of Chengde Medical College,Chengde 067000,Hebei,China;Department of Ultrasound,Baoding No.1 Central Hospital West Hospital,Baoding 071000,Hebei,China)
出处
《医学信息》
2023年第3期109-113,共5页
Journal of Medical Information
关键词
痛风
超声检查
超微血管成像
滑膜增生
Gout
Ultrasonography
Superb microvascular imaging
Synovial hyperplasia
