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安徽省亳州市人民医院超声科,安徽,亳州,236800
纸质出版日期:2022,
网络出版日期:2022-5-5,
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戚建国, 王洲, 李健, 等. 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[J]. 临床超声医学杂志, 2022,24(4).
The value of color Doppler ultrasound combined with VTIQ in evaluating the mobility of the synovial membrane of the wrist in rheumatoid arthritis[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(4).
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。
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.
类风湿性关节炎腕关节声触诊组织成像与量化剪切波
Rheumatoid arthritisWrist jointVirtual touch tissue imaging quantificationShear wave
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