Contrast-enhanced coded phase-inversion harmonic sonography of knee synovitis correlates with histological vessel density: 2 automated digital quantifications.
OBJECTIVE
To use contrast-enhanced coded phase-inversion harmonic B-mode sonography to assess the acoustic enhancement of the synovial area of the knee; and to compare the data with the histological vessel density.


METHODS
Eleven patients eligible for a knee arthroscopy were studied. Acoustic quantification was carried out by a digital image analysis program that detects the time-dependent increase [intensity (time) = k x time + C] of gray-level intensity in all the pixels of a specific region of interest (ROI) following intravenous injection of the microbubble contrast agent sulfur hexafluoride. Echo-guided synovial biopsies were carried out in the same ROI. Synovial vessel areas were quantified after Factor VIII immunostaining of synovial biopsies using an automated digital image analysis.


RESULTS
Significant (p < 0.05) correlations were observed between histological vessel density and percentage of the synovial area with a k value > 0.01 (r = 0.93) and k(max) values (r = 0.79), as well as between the 2 latter parameters (r = 0.72). The histological vessel density and the 2 acoustic parameters were also significantly correlated with the logarithm of erythrocyte sedimentation rate (r = 0.77, r = 0.87, r = 0.67, respectively) and with log C-reactive protein serum concentration (r = 0.69, r = 0.83, r = 0.62, respectively).


CONCLUSIONS
Contrast-enhanced coded phase-inversion harmonic B-mode sonography coupled with an appropriate data analysis method is a new tool to identify and quantify vessel density in knee synovitis.
Department of Rheumatology, GIGA Research, University Hospital Liège, B4000 Liège, Belgium.
Marie-Joëlle
MJ
Kaiser
Jean-Philippe
JP
Hauzeur
Silvia
S
Blacher
Jean-Michel
JM
Foidart
Manuel
M
Deprez
Alexandra
A
Rossknecht
Michel G
MG
Malaise
D000328:Adult; D000368:Aged; D001706:Biopsy; D001799:Blood Sedimentation; D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007719:Knee Joint / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D013583:Synovial Membrane / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D013585:Synovitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology*; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D002097:C-Reactive Protein