Application Of Superb Microvascular Imaging (SMI) And Power Doppr Ultrasound (PDUS) For Diagnosis And Treatment Of Sacro-iliitis In Ankylosing Spondylitis

Objesctive:The aim of this study was to explore the value of the application of superb microvascular imaging(SMI)and power doppler ultrasound(PDUS)for diagnosis and treatment of sacro-iliitis in ankylosing spondylitis.Methods:Two blood flow patterns of SMI and PDUS were used to examine 60 sacroiliac joints on both sides of 30 healthy volunteers and 30 AS patients respectively in this study,the differences of the depiction rate of blood flow?richness of synovial blood flow and the blood flow resistance index(RI)were compared between the two models of blood flow.Then,11 cases of AS patients with remission after treatment were examined by SMI,the blood flow?clinical and laboratory indexes before and after treatment were compared.Results: There is a significant difference in the blood flow richness and RI of sacroiliac joint of the AS patients and healthy volunteers of the two blood flow patterns(P<0.05).In the AS patients,the majority of the blood flow was 2~3 level,while the healthy volunteers was dominated by the blood flow of the 0~1level.The mean RI in the patient group was 0.57±0.07,and the blood flow was mainly low resistance.The mean RI in the control group was 0.67±0.07.High consistency of blood flow classification in two blood flow patterns(Patient group kappa=0.686.control group kappa=0.761,P<0.001).Diagnostic efficacy of the two methods with blood flow richness for diagnosis of sacro-iliitis in AS patients was the same(SMI ROC area 0.783,PDUS ROC area 0.775).The difference of blood flow display rate in two blood flow models is only statistically significant in AS patients(P=0.048),There were significant differences in RI?ESR?CRP and BASDAI Score before and after treatment(P<0.05).Conclusion:1.The blood flow richness and RI of SMI and PDUS can provide an important reference for the diagnosis of sacro-iliitis in AS patients and evaluation of their activity.2.The diagnostic efficacy of SMI and PDUS in the evaluation of sacro-iliitis in AS patients is basically the same.SMI can increase the display rate and elevate the classification of sacroiliac joint synovial blood flow,the blood flow display is clearer.3.There were significant differences in RI?ESR?CRP and BASDAI score before and after the treatment of AS patients with the remission.The RI of blood flow is higher than before treatment.The blood flow RI can be used as an effective index to evaluate the activity of the disease and the curative effect,but the richness of blood flow has little value in judging the effect of the treatment.