Correlation Between Manifestations Of High-frequency Ultrasound And Ceus With Biochemical Indicator Of Knee Joints Lesions In Patients With Rheumatoid Arthritis

Objective:1.To explore the ultrasonic manifestations which undernormal ultrasound or CEUS of the knee in patients with rheumatoid arthritis(RA);2.To explore the correlation between synovium changes of knee jointsunder high-frequency ultrasound or CEUS and biochemical indicator of kneejoints lesions in patients with RA.Methods: With Philips iU22color Doppler ultrasonic diagnosticapparatus, the probe frequency is8-12MHz, select low blood flowconditions of the musculoskeletal in the RA group (72RA patients, including21males and51females. ultrasound examinations were implemented on theside of the knees with serious clinical symptoms.)and the control group (30healthy volunteers, including6males and24females.), The synovium status,including synoyium thickness,degree of hydrops articuli and blood flowcircumstance were observed with high-frequency ultrasound;The synoviummicrocirculation of knee joint of each group was observed with CEUS. Thenthe correlations between the ultrasonic results and anti-cyclic citrullinatedpeptide (Anti-ccp), rheumatoid factor (RF), erythrocyte sedimentation rate(ESR)and c-reactive protein (CRP) of knee joints in RA were analyzed.Results:1High-frequency ultrasound showed only a little synovial fluidexists in the knee joint cavity in the control group, the liquid width <4mm.While the liquid width>4mm in81.94%knee joint cavities of RA group.Synovial membrane is difficult to show under conventional ultrasound in control group,which shows linear strong echo near the suprapatellar bursaliquid and weak echo outside,joint capsule and articular cartilage are difficultto distinguish. The total thickness of the two <2mm. Synovial CEUS renderedas two linear enhancement, thickness <2mm; The RA group synovialsignificantly thickening, thickening of the synovial hypoechoic,CEUS showsclear line between the thickening synovium and joint effusion, it is not even atthickness, their surface is rough, it is thus clear that villiform synoviumconvex to the joint cavity. Exploration and flow signals were not within thecontrol group of30knee synovial. RA group, color Doppler ultrasoundshowed58knee synovial hyperplasia （58/72，80.56%）seen in blood flowsignal, Ⅱ, Ⅲ grade blood flow signal-based（43/72，59.72%），whichperformance of a short rod and mesh flow signals. Conventional ultrasound issometimes difficult to accurately measure the thickness of the synovialthickening, synovial less clear boundaries, synovial uneven contrastenhancement, synovial clearer the synovial thickness increases compared withconventional ultrasound measurements; The control group of30patients withknee articular cartilage surface smooth continuous linear hypoechoic, RAgroup of high-frequency ultrasound knee articular cartilage damage cartilagesurface is rough, strong echo discontinuity performance.2、 Ultrasound visualization showed the formation of pannus andsynovium thickness had correlation with CRP (r=0.36，P＜0.001) and ESR(r=0.49，P＜0.001), the width of hydrops articuli had correlation with CRP(r=0.44，P＜0.001) and ESR (r=0.52，P＜0.001),while synovium thicknesshad correlation with anti-cyclic citrullinated peptide antibody (r=0.44，P=0.033).Conclusion: Ultrasound can show the injury degree in the knees of the patients with RA, CEUS can display the synovium status more specific andmore clear; The high-frequency ultrasonographic and CEUS manifestations ofsynovium changes and knee joints lesions in patients with RA were relevantwith biochemical indicators, which could offer evidences for the diagnosis ofRA. CEUS can directly reflect blood perfusion of the lesion, providereferences for judging the degree of joints lesions in RA patients, guideclinical treatment options and assess the prognosis.