scholarly journals Value of contrast-enhanced ultrasound for detection of synovial vascularity in experimental rheumatoid arthritis: an exploratory study

2019 ◽  
Vol 47 (11) ◽  
pp. 5740-5751 ◽  
Author(s):  
Hui Liu ◽  
Chao Huang ◽  
Shuqiang Chen ◽  
Qing Zheng ◽  
Yuhong Ye ◽  
...  

Objective This study aimed to examine the associations between contrast-enhanced ultrasound (CEUS) imaging and synovial hypervascularity and synovitis score in a rabbit model of antigen-induced arthritis (AIA), compared with power Doppler ultrasound (PDUS). Methods We investigated 50 knee joints in 25 AIA rabbits (AIA group), and 10 knee joints in five sham-injected rabbits (control group). PDUS and CEUS images were evaluated at the 8th week. Ultrasound-guided synovial biopsies were targeted in the area with hypervascularity, and synovial microvessel density (MVD) was evaluated by immunohistochemical staining of CD31. Results The PDUS score was significantly higher in the AIA group (2.61 ± 0.78) compared with the control group (0.50 ± 0.53). CEUS in the AIA group revealed a fast-in/slow-out pattern of contrast enhancement. MVD revealed by CD31+ vessel count and the synovitis score were significantly higher in the AIA group compared with the control group. In the AIA group, CEUS findings showed a better correlation with MVD revealed by CD31+ and synovitis score than PDUS findings. Conclusion CEUS is superior to PDUS for estimating synovial hypervascularity and hyperplasia in experimental rheumatoid arthritis.

2020 ◽  
Author(s):  
Hui Liu ◽  
Chao Huang ◽  
Shuqiang Chen ◽  
Qing Zheng ◽  
Yuhong Ye ◽  
...  

Abstract Objective: This study of rabbits with ovalbumin-induced arthritis (OIA), a model of rheumatoid arthritis (RA), examined the time course of changes in synovial neovascularization based on imaging from power Doppler ultrasound (PDUS) and contrast-enhanced ultrasound (CEUS).Methods: 25 male New Zealand rabbits were in the OIA group and 5 were in the control group. Both rear knee joints of all rabbits were examined using conventional US and CEUS over 16 weeks. The knee synovia of OIA rabbits were sampled by US-guided biopsy, and the expression of CD31 and VEGF were determined by immunohistochemistry. The correlation of microvessel density (CD31 positivity) and VEGF at different times was analyzed using multimodal US.Results: OIA rabbits had increased synovial expression of CD31 and VEGF from week 6 to 12 (P<0.01). During the early stage of CEUS enhancement, dot enhancement was more common on weeks 6 and 8, and strip enhancement was more common on weeks 12 and 16 (P<0.05). There were significant positive correlations of synovial CD31 and VEGF expression with PDI grade, CEUS grade, and peak intensity (PI) (P<0.05 for all).Conclusions: OIA rabbits mimicked early-stage RA at 4 to 8 weeks, middle-stage RA at 8 to 12 weeks, and late-stage RA at 12 to 16 weeks. PDI, CEUS, and PI, especially when combined with CD31 expression, accurately characterized the extent of synovial vascularization. Increased vascular morphology based on CEUS may have value for the early diagnosis of RA.


2018 ◽  
Vol 45 (04) ◽  
pp. 341-347
Author(s):  
Zahraa Ibrahim Selim ◽  
Eman H El-Hakeim ◽  
Eman Ahmed Hamed Omran ◽  
Naglaa K. Idriss ◽  
Marwa A. Gaber ◽  
...  

Abstract Introduction Rheumatoid arthritis (RA) is an autoimmune disease that affects multiple joints causing joint destruction. KIAA1199 is a novel angiogenic biomarker derived from fibroblast-like synoviocytes (FLS) it has a role in acceleration and proliferation of FLS and activation of angiogenic signaling pathways leading to erosion of cartilage and bone. Musculoskeletal ultrasound (MUSU) and Power Doppler (PDUS) directly visualizing the synovial membrane vessels, which is important in providing very early information on the changes in synovitis activity during the course of the inflammatory joint disease Objective To assess the serum level of angiogenic biomarker KIAA1199 in RA patients and its correlation with MSUS, PDUS findings, and the disease activity Patients and methods: Fifty RA patients and 40 healthy control persons age and sex-matched were recruited in this study, KIAA1199 was assessed in the serum of patients and controls, MSUS and PDUS were done for the wrist, elbow, and knee joints for all RA patients Results Serum KIAA1199 level was significantly higher among RA patients 4.36±1.22 ng/dl compared to control group 2.87±0.51 ng/dl (p<0.001). There was a highly significant correlation between KIAA1199 level and DAS28 (p=0.004), and there was a significant correlation between the PDUS with KIAA1199 level and DAS28 (p=0.001, 0.002 respectively) in wrist joints Conclusion KIAA1199 is a new pathway that enhancing cell proliferation and angiogenesis. Serum KIAA1199 level may be a useful biomarker for RA activity, and therapeutic target in RA. PDUS correlates significantly with clinical findings and novel angiogenic biomarker in RA patients.


2009 ◽  
Vol 71 (2) ◽  
pp. 237-241 ◽  
Author(s):  
Hannes Platzgummer ◽  
Gerd Schueller ◽  
Johannes Grisar ◽  
Michael Weber ◽  
Claudia Schueller-Weidekamm

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 985.1-985
Author(s):  
K. Triantafyllias ◽  
S. Liverakos ◽  
C. Noack ◽  
A. Schwarting

Background:Valid assessment of disease activity leads to improvement of long-term outcomes in patients with inflammatory arthritis (1). Optical spectral transmission (OST) is a modern diagnostic tool able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with rheumatoid arthritis (RA) (commercial device: HandScan – Demcon/Hemics, The Netherlands) (2). Even though an increasing number of studies have evaluated diagnostic value of this new technology in RA patients (2,3), no data exist regarding psoriatic arthritis (PsA).Objectives:To examine for the first time the diagnostic value of OST in detecting inflammation in patients with PsA and to evaluate its relationship with disease activity markers and various epidemiological and anthropometric patient characteristics.Methods:OST-Measurements were performed in a group of PsA patients and a group of healthy controls. The difference between OST in the two groups was statistically examined and relationships of OST with clinical (tender / swollen joint counts, disease activity on a visual analogue scale) and serological disease activity markers were evaluated. Moreover, joint ultrasound (US) examinations were performed in a subgroup of PsA patients and OST associations with a Power Doppler- and a Grey Scale-US score were examined. Finally, relationships of OST with various anthropometric and epidemiologic parameters (BMI, hand-size, gender, age) were assessed.Results:We recruited 49 PsA patients [65.3% female; mean age 53.3 years (± 11.8 SD)] and 114 control subjects [77.2% female; mean age 46 years (± 12.8 SD)]. OST was statistically significantly higher in the patient group, compared to the control group [14.95 (12.04 - 17.18, IQR) vs. 10.31 (7.84 – 13.79, IQR); p<0.001]. OST correlated moderately-strongly with both examined US scores (Power Doppler-score: r = 0.5; p = 0.026 and Grey Scale-score: r = 0.52; p = 0.028). Moreover, OST showed a moderate, statistically significant association with C-reactive protein (CRP) (r = 0,298; p = 0,037). Finally, males had significantly higher OST values than females and OST associated moderately-weakly with body mass index (BMI) in the control group (rho = 0.24; p< 0.001).Conclusion:This is the first report of a possible diagnostic value of OST in patients with PsA. OST correlated with ultrasound and serological activity markers and may thus prove to be a useful tool of disease activity assessment, next to well established diagnostic modalities, such as the joint US. Correlations of OST with patient characteristics implicate the need to take also anthropometric and epidemiological patient characteristics into account when interprenting OST results in order to avoid confounding.References:[1]Katchamart W, et al. Systematic monitoring of disease activity using an outcome measure improves outcomes in rheumatoid arthritis. J Rheumatol 2010;37:1411–1415.[2]Triantafyllias, et al. Diagnostic value of optical spectral transmission in rheumatoid arthritis: associations with clinical characteristics and comparison with joint ultrasonography. J Rheumatol 2020 1;47(9):1314-1322.[3]Onna M Van, et al. Assessment of disease activity in patients with rheumatoid arthritis using optical spectral transmission measurements, a non-invasive imaging technique. Ann Rheum Dis 2016;75:511–518.Disclosure of Interests:Konstantinos Triantafyllias Speakers bureau: Pfizer, Novartis, Janssen, Chugai, Stefanie Liverakos: None declared, Claudia Noack: None declared, Andreas Schwarting: None declared


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