| 摘要: |
| 目的：探讨彩色多普勒超声联合VTIQ评估类风湿性关节炎腕关节滑膜活动性的价值。方法：选择64例RA患者(共64个腕关节)为研究对象,依据DAS28评分分为活动组和缓解组。分别对两组患者腕关节行CDFI及VTIQ检查,获取CDFI血流分级及SWV各参数(SWVmax、SWVmin、SWVmeanSWVstd),并比较两组间的差异。绘制滑膜ROC曲线,以AUC比较SWV各参数对滑膜活动性的诊断效能。应用Kappa检验比较CDFI、VTIQ及两者联合对滑膜活动性的评估价值。结果：64个腕关节滑膜中有活动组35个、缓解组29个,活动组患者腕关节CDFI血流分级及SWV各参数均高于缓解组,差异有统计学意义(P< 0.05)。ROC曲线分析发现,SWV各参数中以SWVmean评估滑膜活动性的诊断效能最佳,截断值为4.140m/s时,SWVmean诊断滑膜活动性的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为74.28%、89.29%、79.68%、89.65%及73.52%。CDFI、VTIQ及两者联合对滑膜活动性评估具有较好的一致性(Kappa值分别为0.561、0.628及0.718),且两者联合应用诊断灵敏度、准确度、阴性预测值及Kappa值明显高于单一方法(P＜0.05)。结论：CDFI及VTIQ均可用于类风湿性关节炎滑膜活动性评估,且两者联合应用诊断价值更高。 |
| 关键词: 类风湿性关节炎 腕关节 声触诊组织成像与量化 剪切波 |
| DOI： |
| 投稿时间：2021-05-24修订日期：2022-02-28 |
| 基金项目:亳州市重点研发计划项目（bzzc2019021） |
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| The value of color Doppler ultrasound combined with VTIQ in evaluating the mobility of the synovial membrane of the wrist in rheumatoid arthritis |
| qi jianguo,wang zhou,li jian,ren yongfeng,yin yanhua,wang shanshan |
| () |
| Abstract: |
| Objective: To explore the value of color Doppler ultrasound combined with VTIQ in evaluating the mobility of the wrist synovial membrane in rheumatoid arthritis. Methods: Sixty-four RA patients (64 wrist joints in total) were selected as the research objects, and they were divided into active group and remission group based on DAS28 score. CDFI and VTIQ were performed on the wrist joints of the two groups of patients, and the CDFI blood flow classification and SWV parameters (SWVmax, SWVmin, SWVmeanSWVstd) were obtained, and the differences between the two groups were compared. Draw the ROC curve of the synovial membrane, and compare the diagnostic efficiency of each parameter of SWV on the activity of the synovial membrane with AUC. Kappa test was used to compare the evaluation value of CDFI, VTIQ and the combination of the two on synovial activity. Results: Among the 64 wrist synoviums, there were 35 in the active group and 29 in the remission group. The CDFI blood flow classification and SWV parameters of the wrist in the active group were higher than those in the remission group, and the difference was statistically significant (P<0.05). ROC curve analysis found that SWVmean has the best diagnostic performance for evaluating synovial activity among the various parameters of SWV. When the cut-off value is 4.140m/s, SWVmean has the sensitivity, specificity, accuracy, positive predictive value and positive predictive value for diagnosing synovial activity. The negative predictive values ??were 74.28%, 89.29%, 79.68%, 89.65% and 73.52%, respectively. CDFI, VTIQ and the combination of the two have good consistency in synovial activity evaluation (Kappa values ??are 0.561, 0.628 and 0.718 respectively), and the combined application of the two has significantly higher diagnostic sensitivity, accuracy, negative predictive value and Kappa value In a single method (P<0.05). Conclusion: Both CDFI and VTIQ can be used to assess synovial activity in rheumatoid arthritis, and the combined application of the two has a higher diagnostic value. |
| Key words: Rheumatoid arthritis Wrist joint Virtual touch tissue imaging quantification Shear wave |
