Abstract: Objective: To explore the application value of superb microvascular imaging (SMI) in detecting the synovial blood vessels of knee joint in patients with rheumatoid arthritis (RA), by comparing with contrast-enhanced ultrasound (CEUS). Methods: SMI and CEUS were respectively used to detect and record the blood flow signals of synovium of knee joint of 52 RA patients undergoing total knee arthroplasty (TKA). The consistency of grading of synovial vessels by SMI and CEUS, as well as the correlation between SMI grading and pathological grading were analyzed. Results: There were 104 knee joints in 52 patients, 63 of them underwent total knee arthroplasty. SMI and CEUS all displayed 92.31% (96/104) of the synovial blood flow signals of the knee joint of RA patients, and the consistency between SMI and CEUS was high (Kappa=0.724). Spearman correlation analysis showed that SMI grading was positively correlated with pathological grading (r=0.744, P<0.05). Conclusions: Displaying the synovial blood flow signals of the knee joint of RA patients by SMI was consistent with CEUS; Moreover, SMI can provide some reference value for judging the activity of RA.

Key words: Rheumatoid arthritis, Ultrasound, Superb microvascular imaging, Pathological examination

摘要： 目的: 通过与超声造影（CEUS）技术比较,探讨超微血流成像（SMI）技术检测类风湿关节炎（RA）患者膝关节滑膜血管的应用价值。方法: 分别采用SMI和CEUS技术检测52例拟行全膝关节置换术（TKA）的RA患者膝关节髌上囊滑膜的血流信号,并对滑膜血流信号进行分级。分析SMI技术与CEUS技术检测滑膜血管分级的一致性,以及SMI分级与病理分级的相关性。结果: 52例患者共104个膝关节,行TKA的膝关节63个。SMI、CEUS技术对膝关节滑膜血流信号的显示率均为92.31%（96/104）,两种方法对RA患者滑膜血流信号分级的一致性高（Kappa=0.724）。Spearman相关分析显示,SMI分级与病理分级呈正相关关系（r=0.744,P<0.05）。结论: SMI技术和CEUS技术显示RA患者膝关节滑膜血流信号分级具有一致性,且SMI技术能为判断RA的活动度提供一定的参考价值。

关键词: 类风湿关节炎, 超声检查, 超微血流成像, 病理学检查