Power Doppler sonography in the assessment of synovial tissue of the knee joint in XXXX : a preliminary experience.

@entity1 @entity625 @entity603 @entity158 @entity309
OBJECTIVE: To investigate the intra-articular vascularisation of the synovial pannus in the knee of @entity1 with @entity309 ( @entity309 ) with power Doppler ultrasonography (PDS) and an echo contrast agent and correlate the area under the time-intensity curves with the clinical findings and laboratory measures of disease activity. METHOD: Forty two @entity1 with @entity309 (31 @entity1 , 11 @entity1 ) with history and signs of @entity625 , classified according to a modified index of @entity603 activity (active, moderately active, and inactive), were studied. Clinical and functional assessment (number of swollen joints, intensity of @entity158 , general health-visual analogue scale, disability index-Health Assessment Questionnaire, Ritchie articular index) and a laboratory evaluation were made on all @entity1 . Disease activity was evaluated using the disease activity score (DAS) and the @entity625 systemic index (CASI) for each @entity1 . All @entity1 were examined with conventional ultrasonography and PDS before injection of intravenous ultrasound contrast agent (Levovist). The quantitative estimation of the vascularisation of the synovial membrane was performed with time-intensity curves and calculation of the area under the curves. RESULTS: The mean (SD) value of the area underlying time-intensity curves was 216.2 (33.4) in @entity1 with active @entity603 , 186.8 (25.8) in @entity1 with moderately active @entity603 , and 169.6 (20.6) in those with inactive @entity603 . The mean value of the areas differed significantly between the @entity1 with active and those with inactive @entity603 (p<0.01). The mean value of the area under the curve of the entire group was weakly correlated with the number of swollen joints (p=0.038), but a strong correlation was found with composite indexes of disease activity such as the DAS (p=0.006) and CASI (p=0.01). No correlation was found with age, disease duration, and other laboratory and clinical variables. CONCLUSION: PDS may be a valuable tool to detect fractional vascular volume and to assist clinicians in distinguishing between inflammatory and non-inflammatory pannus. The transit of microbubbles of ultrasound contrast across a tissue can be used to estimate haemodynamic alterations and may have a role in assessing synovial activity and the therapeutic response to treatment of @entity603 of the knee joint.
