Assessment of wrist joint inflammation in patients with rheumatoid arthritis by quantitative two- and three-dimensional power Doppler ultrasonography

Clin Exp Rheumatol. 2014 Sep-Oct;32(5):674-9. Epub 2014 Sep 8.

Abstract

Objectives: We aimed to compare the use of computer-aided quantification methods with 3 different power Doppler ultrasonography (PDUS) modes to assess wrist inflammation in patients with rheumatoid arthritis (RA).

Methods: This study enrolled 49 patients (60 hand joints) with RA. Clinical parameters (rheumatoid factor [RF], erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) were measured and pain was evaluated by a visual analogue scale (VAS, range: 0 to 10). Imaging of the affected wrist joints was performed with 2D- and 3D-PDUS imaging. The 2D imaging used a volumetric transducer and a linear transducer and the 3D imaging employed a volumetric transducer. Software was used to calculate the vascularisation index (VI), flow index (FI), and vascularisation flow index (VFI) under different measurement conditions.

Results: There were 8 males and 41 females, with an average age of 47.59±15.17 years, and average VAS score of 3.63±2.22. In 2D-PDUS with a linear probe, there were significant correlations of ESR with VI and VFI, and of CRP with area, VI, and VFI (p<0.05 for all comparisons). In 3D-PDUS, there was a significant correlation of CRP with VFI (p<0.05). In all 3 measurement modes, there were moderate or high levels of inter- and intra-operator agreement in measurement of area/volume, VI, FI, and VFI.

Conclusions: All 3 PDUS measurement modes had high accuracy and reliability in assessment of wrist inflammation. These results suggest that use of a 3D transducer, which is more expensive and time-consuming, is not necessary for assessment of wrist inflammation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Cross-Sectional Studies
  • Equipment Design
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / instrumentation
  • Image Interpretation, Computer-Assisted / methods*
  • Imaging, Three-Dimensional* / instrumentation
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Reproducibility of Results
  • Severity of Illness Index
  • Taiwan
  • Ultrasonography, Doppler* / instrumentation
  • Wrist Joint / diagnostic imaging*