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Evaluation of finger joint synovial vascularity in patients with rheumatoid arthritis using contrast-enhanced ultrasound with water immersion and a stabilized probe

✍ Scribed by Roberto Stramare; Bernd Raffeiner; Luca Ciprian; Elena Scagliori; Alessandro Coran; Egle Perissinotto; Ugo Fiocco; Valeria Beltrame; Leopoldo Rubaltelli


Publisher
John Wiley and Sons
Year
2012
Tongue
English
Weight
921 KB
Volume
40
Category
Article
ISSN
0091-2751

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✦ Synopsis


Abstract

Purpose.

To assess synovial microvascularity in finger joints with rheumatoid arthritis (RA) by contrast‐enhanced ultrasound (CEUS), distinguishing between cases of active disease and those in remission; to standardize the technique for software analysis.

Methods.

Fifty‐two finger joints of RA patients (26 with active disease and 26 in remission) were immersed in water and examined by CEUS using a fixed probe. Signal intensity curves were calculated with the software.

Results.

Contrast enhancement was detectable in all 26 patients with active RA (100%), but not in 25 of 26 patients in remission (96%); one of the latter patients (4%) showed minimal enhancement. The method's sensitivity and specificity in distinguishing active disease from remission were 100% and 96%. The grades of synovial enhancement correlated with clinical disease activity and software flow parameters. The peak contrast levels correlated with clinical activity, a peak of 9% representing the cutoff between remission and active disease.

Conclusions.

CEUS with a fixed probe on finger joints immersed in water detected synovial vascularization in RA, producing results suitable for standardized software analysis and avoiding artifacts. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012