Objective To investigate the application value of synovial blood flow imaging obtained by Color Superb Microvascular Imaging(cSMI) technology in the treatment of rheumatoid arthritis (RA).Methods Retrospective analysis of 40 hospitalized patients confirmed as wrist rheumatoid arthritis in our hospital.High frequency ultrasound cSMI and pulse doppler（PW） technology were used to dynamically monitor the synovial blood flow classification and arterial resistance index（RI）in wrist before and after treatment for all patients.At the same time，the blood biochemical indexes reflecting the curative effect before and after treatment were recorded respectively: rheumatoid factor (RF), C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and anti cyclic citrullinated peptide antibody (CCP), and the changes of the above parameters before and after treatment were compared.The correlation among blood flow classification, arterial RI in synovium and blood biochemical indexes were analyzed.Results Color flow classification of synovial and RI index of synovial artery in patients with wrist were compared before and after treatment. The differences were statistically significant（all P＜0.05）. Correlation analysis showed that the color flow classification in synovium were all positively correlated with the blood biochemical indexes reflecting the curative effect（correlation coefficients of color flow classification with RF, CRP, ESR and CCP，before treatment：r=0.648、0.369、0.295、0.624，allＰ＜0.05;after treatment: r=0.765、0.559、0.573、0.701，allＰ＜0.05）.There were all negative correlation between RI in the synovial artery and blood biochemical indexes.（correlation coefficient between RI in synovial artery and RF, CRP, ESR and CCP，before treatment：r=-0.682、-0.420、-0.434、-0.798，allＰ＜0.05;after treatment: r=-0.657、-0.549、-0.765、-0.765，allＰ＜0.05).And there were all negative correlation between color flow classification and RI in synovial artery(before treatment：r=-0.820，Ｐ＜0.05;after treatment: r=-0.811，Ｐ＜0.05).Conclusion The color flow classification of synovium and RI of synovial artery based on cSMI technology can dynamically monitor the therapeutic effect of RA patients , so as to provide reliable evidence for clinical practice.