多模态超声成像技术类风湿性关节炎诊断中的临床应用研究

Clinical Application Research of Mutimodal Ultrasound Imaging Technology in the Diagnosis of Synovitis in Rheumatoid Arthritis

摘要: 类风湿性关节炎(rheumatoid arthritis, RA)是一种以滑膜增生、血管翳形成为主要病理特征，累及多个小关节的对称性、侵袭性关节炎症疾病。近年来研究表明，部分RA患者在疾病早期处于亚临床阶段，常规实验室检查及临床体格检查难以察觉，但患者关节内滑膜炎症已悄然发生。因此，若能借助无创超声技术，在早期精准检测出RA患者的滑膜炎症，对于临床医生制定精细化、个体化的诊疗策略，有效遏制病变进展，具有极为重要的临床价值。本综述全面梳理了近年来超声在肌骨诊断领域涌现的新技术，包括超声造影(contrast-enhanced ultrasound, CEUS)、弹性成像(ultrasound elastography, UE)，超声微血流成像(superb microvascular imaging, SMI)以及微血管超分辨显微成像技术(ultrasound resolution microvascular imaging, URM)技术。从技术原理、独特优势及在RA诊断中的临床应用实践、存在的局限性以及未来发展展望等三个维度进行深入剖析与总结，旨在为临床推广应用多模态超声成像技术于RA诊断，尤其是早期诊断工作中提供全面、系统的理论参考与实践指导。

Abstract: Rheumatoid arthritis (RA) is an inflammatory joint disease characterized by synovial hyperplasia and pannus formation, which symmetrically and invasively affects multiple small joints. Recent studies have shown that some RA patients are in a subclinical stage during the early phase of the disease, where conventional laboratory tests and clinical physical examinations are often unable to detect abnormalities, yet synovial inflammation within the joints has already begun. Therefore, the use of non-invasive ultrasound technology to accurately detect synovial inflammation in early-stage RA patients is of significant clinical value, as it enables clinicians to develop refined and personalized diagnosis and treatment strategies, effectively curbing disease progression. This review comprehensively summarizes emerging technologies in musculoskeletal ultrasound diagnostics in recent years, including contrast-enhanced ultrasound (CEUS), ultrasound elastography (UE), superb microvascular imaging (SMI), and ultrasound Resolution microvascular imaging (URM). It provides an in-depth analysis and summary from three perspectives: technical principles, unique advantages, clinical applications in RA diagnosis, existing limitations, and future development prospects. The aim is to offer comprehensive and systematic theoretical references and practical guidance for the clinical promotion and application of multimodal ultrasound imaging technology in RA diagnosis, particularly in early-stage detection.