Logistic Regression Analysis Based On Contrast-Enhanced Ultrasound To Monitor The Progression Of Subclinical Synovitis In Rheumatoid Arthritis And Quantitative Indicators

Objective: Use contrast-enhanced ultrasound(CEUS)to quantitatively evaluate the blood flow of subclinical synovitis in rheumatoid arthritis(RA)and monitor the progress of the disease,and use logistic regression model to screen the most valuable quantitative indicators for predicting disease changes.Methods: 33 cases of RA patients with subclinical synovitis underwent a contrast ultrasound examination of the wrist joints,and then analyzed the data with contrast software to obtain quantitative contrast parameters: start imaging time(AT),peak time(TTP),peak intensity(PI),grad gradient and area under the curve(AUC),CEUS classification of synovial blood supply,and comparison of CEUS blood supply classification with power Doppler(PDUS)blood supply classification,and correlation of quantitative indicators with changes in DAS28 scores Analyze the change in DAS28 score as the dependent variable to determine whether the disease is aggravated,analyze the difference between the quantitative indicators of the disease plus recombination and non-additive recombination,and incorporate statistically significant variables in the univariate analysis into the logistic multivariate analysis to screen and predict disease changes Independent risk factors.Results: 1.The difference between CEUS and PDUS in the classification of intrasynovial blood flow signals was statistically significant(Z=-3.758,P<0.05).2.Contrast-enhanced ultrasound blood supply grading(r=0.655,P < 0.05),AUC(r=0.736,P<0.05),PI(r=0.723,P<0.05)and DAS28 score changes are significantly positively correlated,TTP and DAS28 There was a significant negative correlation with score changes(r=-0.462,P < 0.05).3.Univariate analysis showed that the contrast blood supply grade,TTP,AUC,PI were statistically significant in predicting whether the disease was aggravated(P<0.05),while the grad gradient and AT had no statistically significant difference in predicting whether the disease was aggravated(P >0.05).Further multivariate logistic regression analysis showed that AUC(OR=1.026,95% CI: 1.001-1.052)and PI(OR=1.561,95% CI: 1.019-2.393)are independent risk factors for predicting whether the disease is aggravated.4.Analyze the diagnostic power of AUC and PI in predicting whether the disease is aggravated.The area under the ROC curve of the two is 0.935 and 0.927,respectively,and the difference between the two is not statistically significant.Conclusion: CEUS can detect more microvessels in the synovium of patients with RA subclinical synovitis than PDUS.CEUS is superior to PDUS in the classification of synovial blood flow.There is a good correlation between quantitative angiographic indicators and changes in DAS28 scores.Quantitative angiographic indicators are of high value for predicting disease changes.Among them,AUC and PI are independent risk factors for predicting whether the disease is aggravated,and can provide an objective basis for the formulation of clinical treatment plans.