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中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (04) : 353 -358. doi: 10.3877/cma.j.issn.1672-6448.2020.04.011

所属专题: 文献

肌肉骨骼超声影像学

超微血管成像在痛风血流检测中的应用价值
陆蓓蕾1, 黄备建1,(), 李翠仙1, 郑逢洋1, 王文平1, 王培蕾1, 荆露霞1, 王群1   
  1. 1. 200032 上海,复旦大学附属中山医院超声科 上海市医学影像研究所
  • 收稿日期:2019-06-17 出版日期:2020-04-01
  • 通信作者: 黄备建
  • 基金资助:
    上海自然科学基金(16ZR1433200)

Application of superb microvascular imaging in detection of blood flow in gout

Beilei Lu1, Beijian Huang1,(), Cuixian Li1, Fengyang Zheng1, Wenping Wang1, Peilei Wang1, Luxia Jing1, Qun Wang1   

  1. 1. Department of Ultrasound, Zhongshan Hospital of Fudan University & Shanghai Institute of Medical Imaging, Shanghai 200032, China
  • Received:2019-06-17 Published:2020-04-01
  • Corresponding author: Beijian Huang
  • About author:
    Corresponding author: Huang Beijian, Email:
引用本文:

陆蓓蕾, 黄备建, 李翠仙, 郑逢洋, 王文平, 王培蕾, 荆露霞, 王群. 超微血管成像在痛风血流检测中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2020, 17(04): 353-358.

Beilei Lu, Beijian Huang, Cuixian Li, Fengyang Zheng, Wenping Wang, Peilei Wang, Luxia Jing, Qun Wang. Application of superb microvascular imaging in detection of blood flow in gout[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(04): 353-358.

目的

探讨超微血管成像(SMI)技术在痛风石及滑膜增生血流检测中的应用价值。

方法

收集2017年10月至2018年10月于复旦大学附属中山医院就诊的痛风患者68例,所有患者超声检查时均处于非急性发作期。分别应用能量多普勒(PDI)及SMI技术探测痛风石及增生滑膜内血流信号,并将其分为4级(0~3级)。对SMI与PDI两种模式的痛风石和滑膜增生血流分级进行比较,并分析超敏C反应蛋白(hs-CRP)与SMI和PDI血流分级及滑膜增生程度分级之间的相关性。

结果

不同发作频率组间(0~5、6~10和>10次/年3组)痛风持续时间及hs-CRP差异均有统计学意义(P=0.006、0.003)。痛风石及滑膜增生的SMI血流分级中,高分级(2、3级)患者例数均多于PDI模式,低分级(0、1级)患者例数均少于PDI模式,差异均有统计学意义(Z=-5.385、-2.842,P<0.001、=0.004)。滑膜增生SMI血流分级与hs-CRP相关性最强(r=0.721,P<0.001),其次为滑膜增生PDI分级、滑膜增生程度分级、痛风石SMI分级及痛风石PDI分级(r=0.570、0.563、0.532、0.399,P<0.001、<0.001、<0.001、=0.007)。

结论

SMI对于痛风石及滑膜增生血流具有较好的检测能力,SMI较PDI可探测到更多的血流信号,滑膜增生SMI血流分级与hs-CRP相关性最强,可为痛风活动性评估提供更有价值的诊断信息。

Objective

To assess the application of superb microvascular imaging (SMI) in detecting blood flow in tophi and synovial hyperplasia.

Methods

A total of 68 non-acute gout patients were enrolled at Zhongshan Hospital of Fudan University from October 2017 to October 2018. The blood flow signals in tophi and synovial hyperplasia were detected by power Doppler imaging (PDI) and SMI respectively, and they were divided into four grades (0~3). The differences of blood flow grades detected in tophi and synovial hyperplasia by SMI and PDI were compared, and the correlation between blood flow grades and high-sensitivity C-reactive protein (hs-CRP) was calculated.

Results

There were statistically significant differences in gout duration and hs-CRP between groups with different frequency of attacks (0~5, 6~10, and >10 times/year) (P=0.006 and 0.003). The number of patients with high-grade (grades 2 and 3) tophi and synovial hyperplasia detected by SMI was significantly more than that by PDI, and the number of patients with low-grade (grades 0 and 1) was significantly less than that by PDI (Z=-5.385 and -2.842, respectively; P<0.001, =0.004). The SMI grade of synovial hyperplasia had the highest correlation with hs-CRP (r=0.721, P<0.001), followed by synovial hyperplasia grade, PDI grade of synovial hyperplasia, SMI grade of tophi, and PDI grade of tophi (r=0.570, 0.563, 0.532, and 0.399, respectively; P<0.001, <0.001, <0.001, and =0.007, respectively).

Conclusion

SMI is more sensitive in detecting blood flow in tophi and synovial hyperplasia than PDI. SMI grade of synovial hyperplasia has the highest correlation with hs-CRP, which can provide more valuable diagnostic information for gout activity assessment.

表1 不同痛风发作频率组间患者一般情况比较
图1 膝关节痛风石超声图像。图a为能量多普勒成像显示1级彩色血流信号;图b为超微血管成像显示2级彩色血流信号
图2 第一跖趾关节滑膜增生超声图像。图a为超微血管成像显示2级彩色血流信号;图b为能量多普勒显示1级彩色血流信号
表2 SMI与PDI两种超声模式的痛风石和滑膜增生血流分级比较(例)
表3 不同hs-CRP水平组间的SMI和PDI血流分级比较(例)
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