| 摘要: |
| 目的 比较微血流成像技术（SMI）和能量多普勒超声（PUDS）技术对活动性强直性脊柱炎（AS）患者骶髂关节滑膜血流的丰富程度及显示率的差异，探讨SMI评估活动性AS患者骶髂关节炎的临床价值。方法 分别应用SMI和PDUS两种血流模式检查30例活动性AS患者（病例组）和30例健康志愿者（对照组）左右两侧各60个骶髂关节，对比两组滑膜血流丰富程度、血流显示率的差异。Kappa检验两种模式诊断结果的一致性；受试者工作特征（ROC）曲线计算两种方法的诊断效能。结果 病例组在SMI和PUDS的血流显示率比较差异有统计学意义（P=0.048）；病例组与对照组的血流丰富程度在两种血流模式比较差异均有统计学意义（均P＜O.05）。病例组以2~3级多血流为主，而对照组以0~1级少血流为主；对照组中两种方法对血流分级的一致性较好，病例组中的一致性一般（kappa=0.761、0.686，均P＜0.001）；SMI诊断AS患者骶髂关节炎的ROC曲线下面积为0.783，PDUS的ROC曲线下面积为0.775，差异无统计学意义。结论 SMI和PDUS所测血流丰富程度可作为诊断 AS患者骶髂关节炎及评估其活动性的重要参考依据。两者诊断效能相当，但SMI能够提高骶髂关节滑膜血流的显示率，上调血流级别，血流显示更加清晰，有助于更好地评估AS患者骶髂关节炎的活动性。 |
| 关键词: 微血流成像 能量多普勒 强直性脊柱炎 骶髂关节 滑膜血流 |
| DOI： |
| 投稿时间：2018-04-20修订日期：2019-01-03 |
| 基金项目:彩色多普勒超声骶髂关节检查在早期强直性脊柱炎诊断中的应用价值 |
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| Comparison of superb microvascular imaging(SMI)and power doppr ultrasound(PDUS)of the sacroiliac blood flow in patients with active ankylosing spondylitis |
| fuxiaomeng,gaoxiaoli |
| () |
| Abstract: |
| Objective In this study，the difference of the?depiction?rate and richness of synovial blood flow in the sacroiliac joint（SIJ） of patients with active ankylosing spondylitis（AS） were compared between the two models of blood flow，superb microvascular imaging（SMI）and power doppler ultrasound（PDUS），explored the clinical value of SMI in evaluating SIJ inflammation in patients with active AS.Methods Two blood?flow?patterns?of SMI and PDUS were used to examine 60 sacroiliac?joints on both sides of 30?healthy?volunteers（the control group） and 30 AS?patients（the?patient?group） respectively in this study，the differences of the?depiction?rate of blood flow、richness of synovial blood flow were compared between the two groups.Kappa tested the consistency of diagnostic results of the two models, and ROC curve calculated the diagnostic efficiency of the two methods.Results The difference of blood flow display rate in two blood flow models was only statistically significant in AS patients （P=0.048），There were Statistical differences in the blood flow richness of sacroiliac joint of the AS patients and healthy?volunteers of the two blood?flow?patterns（P＜0.05）.The consistency of blood flow classification under the two blood flow patterns was better in the control group than patient? group（control group kappa=0.761，patient group kappa=0.686，P＜0.001）.There was no significant difference in diagnostic?efficacy?of?the two methods with blood flow richness for?diagnosis?of sacro-iliitis?in AS patients（SMI ?ROC area 0. 783，PDUS?ROC?area?0.775）. Conclusion The blood flow richness of SMI and PDUS can provide an important reference for the diagnosis of sacro-iliitis in AS patients and evaluation of their activity.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 compared with PDUS，SMI has an advantage in evaluating the activity of sacro-iliitis in AS patients. |
| Key words: Superb microvascular imaging Ankylosing spondylitis Sacroiliac joint Synovial blood flow |
