Abstract：
OBJECTIVE: To conduct a comparative study of high-frequency ultrasound and magnetic resonance imaging (MRI) combined with serum RANKL and OPG detection, and assess the efficacy of high-frequency ultrasound with RANKL and OPG detection in screening early rheumatoid arthritis (RA).
METHODS: High-frequency ultrasound and MRI were performed on both carpal joints of 60 patients with early RA, and the frequencies of synovitis, joint effusion, tenosynovitis, and bone erosion detected by high-frequency ultrasound and MRI were observed. The serum levels of receptor activator for nuclear factor-κB ligand (RANKL) and osteoclastogenesis inhibitory factor (OPG) were also detected. The serum levels of RANKL and OPG were also detected in 80 normal healthy examinees. The data were recorded and statistically analyzed.
RESULTS: The detection rates of carpal synovitis, joint effusion, tenosynovitis, and bone erosion in RA patients by high-frequency ultrasound were 81.66%, 69.16%, 63.33%, and 1.66%, respectively, while the detection rates by MRI were 80.00%, 71.66%, 65.00%, and 15.00%, respectively. There was no significant difference between high-frequency ultrasound and MRI in the detection rates of carpal synovitis, joint effusion, and tenosynovitis in RA patients (P > 0.05), while the detection rate of bone erosion by high-frequency ultrasound was significantly lower than that by MRI. The serum levels of RANKL and OPG in RA patients were 231.47 and 68.71, respectively, while the serum levels of RANKL and OPG in normal healthy examinees were 123.51 and 385.05, respectively. The serum RANKL levels of RA patients were significantly higher than those of healthy examinees, while the serum OPG levels of RA patients were significantly lower than those of healthy examinees, which were statistically significant (P < 0.01). The AUC values of the ROC curves obtained by high-frequency ultrasound and MRI combined with serum RANKL and OPG detection in Synovitis modeling were 0.955 and 0.954, respectively. The AUC values of the ROC curves obtained from the joint fusion modeling using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.949 and 0.950, respectively. The AUC values of the ROC curves obtained from modeling Tenosynovitis using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.941 and 0.949, respectively. The AUC values of ROC curves obtained by combining high-frequency ultrasound and MRI with serum RANKL and OPG detection in Bone erosion modeling were 0.908 and 0.923, respectively.
CONCLUSIONS: High-frequency ultrasound combined with serum RANKL and OPG detection has comparable effects to MRI on screening early RA, providing a safe, simple, and cost-effective screening method for the early detection of RA patients. Key Points • High-frequency ultrasound and MRI can effectively detect early lesions of the wrist joints in RA patients. • Ultrasound diagnosis has the advantages of being quick, inexpensive, and repeatable, making it the preferred choice of imaging examination for RA patients at an early stage.
METHODS: High-frequency ultrasound and MRI were performed on both carpal joints of 60 patients with early RA, and the frequencies of synovitis, joint effusion, tenosynovitis, and bone erosion detected by high-frequency ultrasound and MRI were observed. The serum levels of receptor activator for nuclear factor-κB ligand (RANKL) and osteoclastogenesis inhibitory factor (OPG) were also detected. The serum levels of RANKL and OPG were also detected in 80 normal healthy examinees. The data were recorded and statistically analyzed.
RESULTS: The detection rates of carpal synovitis, joint effusion, tenosynovitis, and bone erosion in RA patients by high-frequency ultrasound were 81.66%, 69.16%, 63.33%, and 1.66%, respectively, while the detection rates by MRI were 80.00%, 71.66%, 65.00%, and 15.00%, respectively. There was no significant difference between high-frequency ultrasound and MRI in the detection rates of carpal synovitis, joint effusion, and tenosynovitis in RA patients (P > 0.05), while the detection rate of bone erosion by high-frequency ultrasound was significantly lower than that by MRI. The serum levels of RANKL and OPG in RA patients were 231.47 and 68.71, respectively, while the serum levels of RANKL and OPG in normal healthy examinees were 123.51 and 385.05, respectively. The serum RANKL levels of RA patients were significantly higher than those of healthy examinees, while the serum OPG levels of RA patients were significantly lower than those of healthy examinees, which were statistically significant (P < 0.01). The AUC values of the ROC curves obtained by high-frequency ultrasound and MRI combined with serum RANKL and OPG detection in Synovitis modeling were 0.955 and 0.954, respectively. The AUC values of the ROC curves obtained from the joint fusion modeling using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.949 and 0.950, respectively. The AUC values of the ROC curves obtained from modeling Tenosynovitis using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.941 and 0.949, respectively. The AUC values of ROC curves obtained by combining high-frequency ultrasound and MRI with serum RANKL and OPG detection in Bone erosion modeling were 0.908 and 0.923, respectively.
CONCLUSIONS: High-frequency ultrasound combined with serum RANKL and OPG detection has comparable effects to MRI on screening early RA, providing a safe, simple, and cost-effective screening method for the early detection of RA patients. Key Points • High-frequency ultrasound and MRI can effectively detect early lesions of the wrist joints in RA patients. • Ultrasound diagnosis has the advantages of being quick, inexpensive, and repeatable, making it the preferred choice of imaging examination for RA patients at an early stage.
摘要：
目的：进行高频超声和磁共振成像（MRI）联合血清RANKL和OPG检测的比较研究，并评估高频超声结合RANKL和OPG检测在筛查早期类风湿关节炎（RA）中的功效。
方法：对60例早期RA患者的腕关节进行高频超声和MRI检查，和滑膜炎的频率，关节积液,腱鞘炎,观察高频超声和MRI检测的骨侵蚀。还检测了血清中核因子-κB受体激活剂配体（RANKL）和破骨细胞生成抑制因子（OPG）的水平。还在80名正常健康体检者中检测了血清RANKL和OPG水平。记录数据并进行统计学分析。
结果：腕关节滑膜炎的检出率，关节积液,腱鞘炎,高频超声检查RA患者的骨侵蚀率为81.66%，69.16%，63.33%,1.66%，分别,而MRI的检出率为80.00%,71.66%,65.00%,和15.00%，分别。高频超声与MRI对腕关节滑膜炎的检出率差异无统计学意义,关节积液,RA患者的腱鞘炎（P>0.05），高频超声对骨侵蚀的检出率明显低于MRI。RA患者血清RANKL和OPG水平分别为231.47和68.71,正常健康体检者血清RANKL和OPG水平分别为123.51和385.05。RA患者血清RANKL水平明显高于健康体检者,RA患者血清OPG水平明显低于健康体检者,差异有统计学意义(P<0.01)。高频超声和MRI联合血清RANKL和OPG检测滑膜炎模型的ROC曲线的AUC值分别为0.955和0.954。高频超声和MRI联合血清RANKL和OPG检测联合融合建模得到的ROC曲线的AUC值分别为0.949和0.950。采用高频超声和MRI联合血清RANKL和OPG检测对腱鞘炎建模的ROC曲线的AUC值分别为0.941和0.949。高频超声和MRI结合血清RANKL和OPG检测在骨侵蚀模型中获得的ROC曲线的AUC值分别为0.908和0.923。
结论：高频超声联合血清RANKL和OPG检测对早期RA的筛查效果与MRI相当。提供保险箱,简单,和经济有效的筛查方法，用于早期发现RA患者。要点•高频超声和MRI可有效发现RA患者腕关节的早期病变。•超声诊断具有快速的优点，便宜,并且可重复，使其成为早期RA患者影像学检查的首选。
方法：对60例早期RA患者的腕关节进行高频超声和MRI检查，和滑膜炎的频率，关节积液,腱鞘炎,观察高频超声和MRI检测的骨侵蚀。还检测了血清中核因子-κB受体激活剂配体（RANKL）和破骨细胞生成抑制因子（OPG）的水平。还在80名正常健康体检者中检测了血清RANKL和OPG水平。记录数据并进行统计学分析。
结果：腕关节滑膜炎的检出率，关节积液,腱鞘炎,高频超声检查RA患者的骨侵蚀率为81.66%，69.16%，63.33%,1.66%，分别,而MRI的检出率为80.00%,71.66%,65.00%,和15.00%，分别。高频超声与MRI对腕关节滑膜炎的检出率差异无统计学意义,关节积液,RA患者的腱鞘炎（P>0.05），高频超声对骨侵蚀的检出率明显低于MRI。RA患者血清RANKL和OPG水平分别为231.47和68.71,正常健康体检者血清RANKL和OPG水平分别为123.51和385.05。RA患者血清RANKL水平明显高于健康体检者,RA患者血清OPG水平明显低于健康体检者,差异有统计学意义(P<0.01)。高频超声和MRI联合血清RANKL和OPG检测滑膜炎模型的ROC曲线的AUC值分别为0.955和0.954。高频超声和MRI联合血清RANKL和OPG检测联合融合建模得到的ROC曲线的AUC值分别为0.949和0.950。采用高频超声和MRI联合血清RANKL和OPG检测对腱鞘炎建模的ROC曲线的AUC值分别为0.941和0.949。高频超声和MRI结合血清RANKL和OPG检测在骨侵蚀模型中获得的ROC曲线的AUC值分别为0.908和0.923。
结论：高频超声联合血清RANKL和OPG检测对早期RA的筛查效果与MRI相当。提供保险箱,简单,和经济有效的筛查方法，用于早期发现RA患者。要点•高频超声和MRI可有效发现RA患者腕关节的早期病变。•超声诊断具有快速的优点，便宜,并且可重复，使其成为早期RA患者影像学检查的首选。
