The Application Value Of Shear Wave Elastography In Rheumatoid Arthritis With Peripheral Neuropathy

Objective:To explore the feasibility of shear wave elastography?SWE?to evaluate patients with peripheral neuropathy?PN?in rheumatoid arthritis?RA?.The correlation between the RA activity of the RA and PN group and the mean Young's modulus?E value?of the median nerve was analyzed.Methods:According to nerve conduction study?NCS?in the case group,the positive patients were divided into 60 patients with RA with PN group?group A?,and 55patients with RA without PN group?group B?.And 50 healthy control group?group C?.At the entrance of the carpal tunnel of the median nerve,ultrasound measures the left and right diameter(D_W1),anterior and posterior diameter(D_W2),perimeter?C_W?and cross-sectional area?CSA_W?,using the SWE technique to measure the E value of the midpoint of the forearm of the median nerve.Compare the differences between the groups and draw a receiver operator characteristic?ROC?curve.Record the correlation between the RA activity of Group A and the E value.Results:There was no significant difference in D_W11 between the three groups,D_W1,C_W and CSA_W between group B and group C?P>0.05?.Compared with group B and group C,D_W1,C_W and CSA_W increased in group A,the difference was statistically significant?P<0.01?.The E value comparison between the three groups was statistically significant?P<0.001?.The area under the ROC curve corresponding to the E value,CSA_W,C_W and D_W1 were 0.827,0.801,0.740 and 0.747 respectively.The best cut-off value of E value in the diagnosis of RA and PN is set to 65.0kPa,and its sensitivity and specificity are 85.7%.RA activity in group A was positively correlated with E value?r_s=0.791,P<0.05?.Conclusion:1.Compared with the two-dimensional parameters(D_W1,C_W and CSA_W)between the groups,there are differences between group A and group C,and there are no difference between group B and group C,which indicates that ultrasound only can find typical PN but cannot identify subclinical type.2.The color images and E values obtained by applying SWE are statistically different between the three groups,which indicates that SWE can qualitatively and quantitatively assess the degree of nerve injury and provide an intuitive and reliable basis for early clinical diagnosis.3.The E value measured by SWE was the most effective in RA with PN patients above all.Its sensitivity and specificity are the highest?both 85.7%?when the optimal cutoff value for diagnosis is set to 65.0KPa.4.RA activity is positively correlated with E value in group RA and PN.