How useful is contrast-enhanced ultrasound in rheumatoid arthritis? A systematic review with meta-analysis on the comparison between contrast-enhanced ultrasound and colour or power Doppler ultrasound.
IF 4.8 1区 医学Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Joaquim Polido-Pereira, Manuel Silvério António, Susana Oliveira Henriques, João Sabido, Ricardo M Fernandes, Elsa Vieira-Sousa, Maria Antonietta D'Agostino, João Eurico Fonseca
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引用次数: 0
Abstract
Objective: The primary objective was to evaluate the additional benefits of contrast-enhanced ultrasound (CEUS) compared to unenhanced Doppler ultrasound (DUS) for the identification of active synovitis in rheumatoid arthritis (RA).
Methods: We searched PubMed/MEDLINE and EMBASE (February 2024) for all English-written published reports of human studies including the use of CEUS for the study of synovitis in RA. The risk of bias of included studies was evaluated using the QUADAS tool. DUS and CEUS semiquantitative scores were transformed in binomial, and these data were extracted for meta-analysis. Results that we were unable to quantitatively aggregate were summarised qualitatively.
Results: Twenty-three studies using CEUS to evaluate 1117 joints from 827 subjects were included, of which 898 joints were from 669 RA patients. We performed a meta-analysis of 9 studies in active RA patients showing that from 474 joints evaluated by either PDUS/CDUS and CEUS, the synovitis detection was 49.2% and 83.8%, respectively, corresponding to a relative detection ratio (RDR) of 1.49 (95% CI 1.23-1.81) favouring CEUS. Heterogeneity of the data was moderate. In healthy subjects, CEUS detected no vascularisation in 4 studies.
Discussion: CEUS detects more microvascularisation than PDUS in active RA with an RDR of 1.49.
目的：主要目的是评估对比增强超声（CEUS）与非增强多普勒超声（DUS）在识别类风湿关节炎（RA）的活动性滑膜炎方面的额外益处。方法：我们检索PubMed/MEDLINE和EMBASE（2024年2月）所有英文撰写的人类研究报告，包括使用超声造影研究RA滑膜炎。使用QUADAS工具评估纳入研究的偏倚风险。将DUS和CEUS半定量评分转化为二项，并提取这些数据进行meta分析。我们无法定量汇总的结果进行了定性总结。结果：纳入23项研究，使用超声造影评估来自827名受试者的1117个关节，其中来自669名RA患者的898个关节。我们对活动期RA患者的9项研究进行了荟萃分析，结果显示，通过PDUS/CDUS和CEUS评估的474个关节中，滑膜炎的检出率分别为49.2%和83.8%，相对检出率（RDR）为1.49 (95% CI 1.23-1.81)，有利于CEUS。数据的异质性为中等。在健康受试者中，超声造影在4项研究中未检测到血管化。讨论：在活动期RA中，CEUS比pdu检测到更多的微血管化，RDR为1.49。
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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