title: Evaluation of finger joint synovial vascularity in patients with rheumatoid arthritis using contrast-enhanced ultrasound with water immersion and a stabilized probe.
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.
authors.affiliation: Department of Medical Diagnostic Sciences and Special Therapies, University of Padua Medical School, Padua, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Stramare
authors.forename: Bernd
authors.initials: B
authors.lastname: Raffeiner
authors.forename: Luca
authors.initials: L
authors.lastname: Ciprian
authors.forename: Elena
authors.initials: E
authors.lastname: Scagliori
authors.forename: Alessandro
authors.initials: A
authors.lastname: Coran
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.forename: Ugo
authors.initials: U
authors.lastname: Fiocco
authors.forename: Valeria
authors.initials: V
authors.lastname: Beltrame
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Rubaltelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D005384:Finger Joint / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007101:Immersion; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D015588:Observer Variation; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D013583:Synovial Membrane / Q000098:blood supply* / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000295:instrumentation; D014867:Water
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D014867:Water; D013459:Sulfur Hexafluoride