摘要
目的探讨超声造影(CEUS)检查在类风湿关节炎患者中的早期诊断及与预后的相关性。方法选取类风湿性关节炎患者48例,均行CEUS检查,检测治疗前CDFI、CEUS分级与28个关节疾病活动指数(28 joint disease activ-ity index,DAS28)评分的关系;对于确诊患者均行常规方法治疗,3个月后评估效果;采用Pearson相关性分析软件对超声造影检查结果与生化指标进行相关分析。结果48例患者治疗前DAS28评分分级显示:0级8例、I级13例,II级11例及III级16例。CEUS分级结果与DAS28评分具有相关性,Kappa值为0.547(P<0.05);患者治疗后滑膜面积、峰值强度、曲线下面积、半降时间、内洗斜率均低于治疗前,达峰时间长于治疗前,差异有统计学意义(P<0.05);患者治疗3个月后RF、CRP、ESR及抗CCP水平均低于治疗前,差异有统计学意义(P<0.05);Pearson相关性分析结果表明:类风湿关节炎患者RF、CRP、ESR及抗CCP水平与滑膜面积、峰值强度、曲线下面积、半降时间、内洗斜率呈正相关性(P<0.05);与达峰时间呈负相关性(P<0.05)。结论CEUS检查用于类风湿关节炎患者早期能准确的评估关节滑膜炎活动性,其CEUS指标与预后存在强相关性,可为临床治疗方案的制订、病情判断及疗效评估提供客观依据。
Objective To explore the early diagnosis of contrast-enhanced ultrasound(CEUS)in patients with rheumatoid arthritis and its correlation with prognosis.Methods 48 patients with rheumatoid arthritis admitted were selected as the subjects,all of whom underwent CEUS examination.The relationship between CDFI,CEUS grading,and 28 Joint Disease Activity Index(DAS28)scores before treatment was tested;For confirmed patients,routine treatment was performed and the patient's effectiveness was evaluated after 3 months;Pearson correlation analysis software was used to analyze the correlation between ultrasound contrast examination results and biochemical indicators.Results The DAS28 score grading of 48 patients before treatment showed 8 cases at level 0,13 cases at level I,11 cases at level II,and 16 cases at level III.The CEUS grading results were correlated with the DAS28 score,with a Kappa value of 0.547(P<0.05);After treatment,the synovial area,peak intensity,area under the curve,half descent time,and internal washing slope of the patient were all lower than those before treatment(P<0.05);The peak time was longer than before treatment(P<0.05);After 3 months of treatment,the levels of RF,CRP,ESR,and anti CCP in patients were lower than those before treatment(P<0.05);The Pearson correlation analysis results showed that the levels of RF,CRP,ESR,and anti CCP in rheumatoid arthritis patients were positively correlated with synovial area,peak intensity,area under the curve,half time of decline,and washout slope(P<0.05);There was a negative correlation with the peak time(P<0.05).Conclusion CEUS can accurately evaluate the activity of synovitis in patients with rheumatoid arthritis in the early stage,and its contrast-enhanced ultrasound indicators have a strong correlation with prognosis.It can provide objective basis for clinical treatment plan formulation,disease judgment,and efficacy evaluation.
作者
蒋俊杰
李巧凤
曾鸽
JIANG Junjie;LI Qiaofeng;ZENG Ge(Department of Ultrasound,special examination department,Huzhou Third People's Hospital,Huzhou 313000,China)
出处
《医学影像学杂志》
2024年第6期125-128,共4页
Journal of Medical Imaging
基金
浙江省医药卫生科技计划项目(编号:2021KY1098)。
关键词
超声造影
类风湿关节炎
早期诊断
相关性
Contrast-enhanced Ultrasonography
Rheumatoid arthritis
Early diagnosis
Correlation
