The Application Of Ultrasonography Scores And Contrast-enhanced Ultrasonography In Rheumatoid Arthritis

Objective To investigate the diagnostic value of ultrasonography scores for evaluation of activity in rheumatoid arthritis(RA).Methods Thirty nine patients in rheumatoid arthritis were included in the study.The metacarpophalangeal,proximal interphalangeal,wrist,elbow and knee joints of the patients were examined by high frequency ultrasound for evaluation of synovial thickness,synovial blood flow,joint effusion and bone erosion.The ultrasonography findings were scored(0~3) and the sum scores of joints in each patients were calculated.The relationship between the ultrasonography scores,DAS28 scores and biochemical examinations(ESR,CRP,RF,Anti-CCP) were analysised.Results The ultrasonography scores were significantly correlated with DAS28 Scores(r=0.823,P<0.01).The correlation between ultrasonography scores and CRP is better than that between DAS28 scores and CRP(r超声评分=0.692,r DAS28=0.526,P<0.01).The synovial thickness in ultrasonography scores were correlated with DAS28 Scores and biochemical examinations(ESR,CRP)(r DAS28=0.852,r ESR=0.779,r CRP=0.587,P<0.01).Conclusion The ultrasonography scores coincided with DAS28 Scores and biochemical examinations(ESR,CRP) in diagnosis of activity in rheumatoid arthritis.The ultrasonography scores may be better than DAS28 Scores and is a useful method for evaluation of activity in rheumatoid arthritis.The synovial thickness in ultrasonography scores best reflects the activity.Objective To investigate the diagnostic value of contrast-enhanced ultrasonography(CEUS) for evaluation of activity in rheumatoid arthritis(RA).Methods Twelve patients in rheumatoid arthritis were included in the study.The most severe joints were fully exposed.The related index including synovial thickness,synovial blood flow,joint effusion and bone erosion were examined by high frequency ultrasound.The findings were scored(0~3) and the sum scores of joints in each patients were calculated. Then contrast mode was selected,2.4ml Sono Vue was injected by cubital vein and the enhanced of synovial was observed. Then got ROIs time-intensity curve and analyzed parameters including area under curve(AUC),peak intensity(PI) and time to peak(TTP).Investigated the relationship among each parameters and ultrasonography scores and biochemical examinations(ESR,CRP,RF,anti-CCP).Results The AUC and PI in CEUS were significantly correlated with ultrasonography scores(r AUC=0.832,r PI=0.809,P<0.01).The correlation among AUC,PI and ESR is better than that among ultrasonography scores and ESR(r AUC=0.907,r PI=0.851,r超声评分=0.836,P<0.01).The correlation among AUC,PI and CRP is better than that among ultrasonography scores and CRP(r AUC=0.855,r PI=0.854,r超声评分=0.692,P<0.01).Conclusions The CEUS coincided with DAS28 Scores and biochemical examinations(ESR,CRP) in diagnosis of activity in rheumatoid arthritis.The CEUS may be better than ultrasonography scores and is a useful method for evaluation of activity in rheumatoid arthritis.