Document Detail


Power Doppler ultrasonography and synovitis: correlating ultrasound imaging with histopathological findings and evaluating the performance of ultrasound equipments.
MedLine Citation:
PMID:  16707536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine the validity of power Doppler ultrasound imaging to identify synovitis, using histopathology as gold standard, and to assess the performance of ultrasound equipments. METHODS: 44 synovial sites in small and large joints, bursae and tendon sheaths were depicted with ultrasound. A synovial biopsy was performed on the site depicted and a synovial sample was taken for histopathological evaluation. The performance of three ultrasound devices was tested using flow phantoms. RESULTS: A positive Doppler signal was detected in 29 of 35 (83%) of the patients with active histological inflammation. In eight additional samples, histological examination showed other pathological synovial findings and a Doppler signal was detected in five of them. No significant correlation was found between the amount of Doppler signal and histological synovitis score (r = 0.239, p = NS). The amount of subsynovial infiltration of polymorphonuclear leucocytes and surface fibrin correlated significantly with the amount of power Doppler signal: r = 0.397 (p<0.01) and 0.328 (p<0.05), respectively. The ultrasound devices differed in showing the smallest detectable flow. CONCLUSIONS: A negative Doppler signal does not exclude the possibility of synovitis. A positive Doppler signal in the synovium is an indicator of an active synovial inflammation in patients. A Doppler signal does not correlate with the extent of the inflammation and it can also be seen in other synovial reactions. It is important that the quality measurements of ultrasound devices are reported, because the results should be evaluated against the quality of the device used.
Authors:
J M Koski; S Saarakkala; M Helle; U Hakulinen; J O Heikkinen; H Hermunen
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-17
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  65     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-19     Completed Date:  2006-12-14     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1590-5     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Mikkeli Central Hospital, Porrassalmenkatu 35-37, 50100 Mikkeli, Finland. f.koski@fimnet.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Antirheumatic Agents / therapeutic use
Arthritis / drug therapy,  ultrasonography
Biopsy
Female
Humans
Male
Middle Aged
Phantoms, Imaging
Quality Assurance, Health Care / methods
Reproducibility of Results
Severity of Illness Index
Synovitis / pathology,  ultrasonography*
Transducers / standards
Ultrasonography, Doppler / instrumentation*,  methods,  standards
Chemical
Reg. No./Substance:
0/Antirheumatic Agents
Comments/Corrections

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