Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The detection of power Doppler (PD) ultrasound signals in joints may be considered as the presence of joint inflammation, i.e., synovitis which is a predictor of erosive progression in rheumatoid arthritis (RA). Superb Microvascular Imaging (SMI), a novel ultrasonography, is based on the sensitive Doppler technology with low-motion artifacts than conventional power Doppler ultrasound (cPDUS); furthermore, it can detect low-velocity blood flow signals with high resolution frame rates. Therefore, we evaluated PD ultrasound signals in patients with rheumatic diseases using SMI and cPDUS, and compared the correlations of these signals to clinical and laboratory assessments by these two imaging modalities. Moreover, we also investigated PD ultrasound signals in the difference between synthetic and biological disease-modifying antirheumatic drugs in patients with RA.
Methods: Twenty-seven patients with RA and 11 non-RA patients with rheumatic diseases were enrolled. We assessed PD signals in the finger, hand, elbow, and knee joints (total 26 joints) by the SMI and cPDUS findings using Aplio 300 (Toshiba Medical Systems). The signals were semiquantified into 4 grades (OMERACT standard, grades 0–3). These individual scores added together to calculate the total SMI score or total cPDUS score (0-114).
Results: The total SMI score was significantly higher than the total cPDUS score in patients with RA (SMI 12.3±11.5 vs. cPDUS 5.2±8.1, p<0.001). On the other hand, there was no significant difference between the total SMI and cPDUS scores in patients with non-RA (SMI 0.6±0.7 vs. cPDUS 0.3±0.6, p=0.1320). Serum CRP and MMP-3 levels, and HAQ-DI score significantly correlated with the total SMI score in patients with RA (CRP: r=0.51, p=0.006; MMP-3: r=0.52, p=0.006; HAQ-DI score: r=0.41, p=0.040). However, these data did not show up the result of correlation with the total cPDUS score (CRP: r=0.22, p=0.260; MMP-3: r=0.26, p=0.205; HAQ-DI score: r=0.21, p=0.295). In non-methotrexate-treated patients with RA, the total SMI score was significantly higher than the total cPDUS score (n=19, SMI 13.3±11.8 vs. cPDUS 4.1±6.2, p=0.001). In contrast, in methotrexate-treated patients with RA, there was no significant difference between the total SMI and cPDUS scores (n=8; SMI 10.0±10.5 vs. cPDUS 7.8±12.1, p=0.188).
Conclusion: Our results suggest that SMI can detect PD ultrasound signals more sensitively than cPDUS in patients with RA. Furthermore, it is a requirement for us to pursuit the result of analysis using SMI and cPDUS.
To cite this abstract in AMA style:Yokota K, Wada TT, Akiyama Y, Mimura T. Detection of Power Doppler Ultrasound Signals in Rheumatic Diseases Using Superb Microvascular Imaging (SMI): Comparison with Conventional Power Doppler Ultrasound [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/detection-of-power-doppler-ultrasound-signals-in-rheumatic-diseases-using-superb-microvascular-imaging-smi-comparison-with-conventional-power-doppler-ultrasound/. Accessed April 2, 2020.
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