[Diagnostic value of ultrasound imaging in chronic gouty arthritis].

OBJECTIVE: To determine the diagnostic value of ultrasound imaging in chronic gouty arthritis. METHODS: Ultrasound imaging of 32 patients with chronic gouty arthritis were compared with those of 36 patients with non-gouty joint diseases. A logistic model was obtained to establish the associations between ultrasound appereances and gouty arthritis. Receiver operator characteristic (ROC) curve was constructed to evaluate the performance of the logistic model. RESULTS: A double contour sign of articular cartilage, a snowstorm appearance of the joint fluid, and a hyperecho around the periarticular tendon had diagnostic value for chronic gouty arthritis. According to the logistic regression analysis, the accuracy of predicting chronic gouty arthritis was 95.59% (65/ 68), and the area under curve of ROC was 3.987 +/- 0.011 (P < 0.05). CONCLUSION: A double contour sign of articular cartilage, a snowstorm appearance of the joint fluid, and a hyperecho around the periarticular tendon have diagnostic value. The combination of these appearances can improve diagnosis of chronic gouty arthritis.

[Progress of ultrasound microbubble contrast technology in the diagnosis and treatment of clinical diseases].

Contrast enhanced ultrasound (CEUS) technology has made important developments over the past decade. It has been applied in the clinical diagnosis for various diseases of multiple organs including liver, kidney, thyroid, breast and so on, which greatly improves the accuracy of ultrasound diagnosis. The emergence of targeted ultrasound microbubble makes ultrasound molecular imaging possible. More than the improvement of ultrasound imaging, microbubble contrast agent also could be an effective drug or gene carrier. Microbubble will rupture under the irradiation effect of local ultrasound, and then the carried drugs or genes will be released to achieve the purpose of targeted therapy. We should pay more attention on the progress of ultrasound microbubble contrast technology in clinical and basic research. It will promote better understanding and clinical applications of this novel medical ultrasound technology.

[Enhanced local gene transfection in rats with injured achilles tendons and granulation tissues using ultrasound and microbubble].

OBJECTIVE: To identify best local ukrasound transfection conditions in rats with injured achilles tendons and granulation tissues. METHODS: Rat models with bilateral injured achilles tendons were established. A mixture of microbubbles and enhanced green fluorescent protein (EGFP) plasmids were injected into the achilles tendons. The injured tendons were subject to ultrasound irradiation under different output intensity, duty cycle and irradiation time. The rats were divided into four groups: (1) plasmid+microbubbles- ultrasound (PL+MB+US); (2)plasmid + microbubble (PL+MB); (3)plasmid + ultrasound (PL+US); (4) plasmid only (PL). We identified the best ultrasound conditions based on the highest transfection efficiency in the achilles tendons and granulation tissues and the least normal tissue damage. RESULTS: Under the condition of 2 W/cm2 power output and 20% duty cycle of ultrasound irradiation for 10 min, EGFP expression was demonstrated in the achilles tendons and granulation tissues without showing significant damage to normal tissues. Higher levels of EGFP expression were found in the group of PL+ MB+ US than the other groups (no significant differences in EGFP expression were found among the other three groups). CONCLUSION: Under proper conditions, ultrasound and microbubble can enhance in vivo gene transfection efficiency in rats with injured achilles tendons and granulation tissues without causing obvious normal tissue damage, which could provide a sound basis for experimental study of gene therapy for injured tendons.

[Correlation between quantitative results of contrast-enhanced ultrasonography and clinical and laboratory indexes for synovium of patients with rheumatoid arthritis ].

OBJECTIVE: To determine the correlation between quantitative results of contrast enhanced ultrasound and clinical and laboratory index for synovium of patients with rheumatoid arthritis (RA). METHODS: Thirty five RA patients participated in this study, with ten normal adults serving as controls. They were given a score of DAS28 and underwent laboratory tests, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Contrast-enhanced ultrasound examinations were performed to detect thickness of synovium (2D and Power Dopple). RESULTS: Peak intensity (PI) and area under the curve (AUC) were positively correlated with ESR, CRP and DAS28 score, respectively (P<0. 01). The rest of ultrasound parameters had no significant correlations with ESR, CRP and DAS28 score (P>0. 05). Synovium thickness identified by contrast enhanced ultrasound had significant correlations with ESR, CRP and DAS28 score (P < 0. 01). CONCLUSION: Synovium thickness determined by contrast enhanced ultrasound, PI and AUC can serve as an index estimating inflammatory activity of RA, and provide evidence for clinical diagnosis and treatment.