Detection of Increased Vascular Signal in Arthritis-Prone Rats Without Joint Swelling Using Superb Microvascular Imaging Ultrasonography

Abstract

This study aimed to determine whether ultrasonography (US) can detect increased vascular signal in the synovial tissue prior to overt synovitis in rheumatoid arthritis (RA). Env-pX rats that spontaneously develop RA-like synovitis were used. Ankle joints of 15 pre-morbid env-pX rats were observed with power Doppler and superb microvascular imaging (SMI) using an ultrahighfrequency (8-24 MHz) probe. Signal values were counted as the number of pixels. The total number of vessels and vessel area in the synovial tissue were histologically evaluated. Dilated vessels were determined from the mean value of synovial vessels in three wild-type rats. In all env-pX rats, apparent synovial proliferation was not observed. However, vasodilation was evident. Only SMI values were significantly correlated with the number of dilated vessels (r=0.585, p=0.022) but not with the total number of vessels. US with SMI using ultrahighfrequency probe can detect increased vascular signal in the synovial tissue of arthritis-prone rats.

The Use of Superb Microvascular Imaging in Evaluating Rheumatic Diseases: A Systematic Review

“…Overall, 19 original studies of SMI application in rheumatology were found and 18 [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] of them were analysed because we were not able to obtain the full text of one publication. The majority of the included studies were conducted in Japan [ 11 , 12 , 13 , 14 , 15 ], China [ 16 , 17 , 18 , 19 , 20 ], and Turkey [ 21 , 22 , 23 , 24 ]; single studies were conducted in Australia [ 25 ], Italy [ 26 ], South Korea [ 27 ] and the United Kingdom [ 28 ]. Reference screening provided three additional papers, but only one fulfilled the inclusion criteria and was included for analysis [ 20 ].…”

“…Supplemental Table S1 depicts the baseline characteristics of the identified studies and enrolled patients. The most studied rheumatic disease was RA (52.63% of studies) [ 11 , 12 , 13 , 14 , 16 , 18 , 19 , 20 , 26 ] representing up to 63.15% of the studies when analysed in a mixed sample together with non-RA arthritis [ 15 , 28 ]. The main target of the research was synovial vascularity of the joints (84.21%).…”

Contribution of the Ultrasound Techniques in the Evaluation of Knee Joint Damage in the Case of Pigmented Villonodular Synovitis and Rheumatoid Arthritis

“…Studies have shown that SMI played an important role on evaluation of RA activity, especially in subclinical synovitis than in clinical. 15,16 However, there were few studies on the application of SMI in PVNS. In our study, SMI can indeed improve the detection rate of synovial blood flow and the grade of synovial blood flow.…”

“…Compared with CDFI, SMI can improve the detection rate of synovial blood flow and the grade of synovial blood flow. Studies have shown that SMI played an important role on evaluation of RA activity, especially in subclinical synovitis than in clinical 15,16 . However, there were few studies on the application of SMI in PVNS.…”

Fluvastatin prevents the development of arthritis in env-pX rats via up-regulation of Rho GTPase-activating protein 12

“…To monitor the progression of synovitis chronologically, joint US was used in this study. Up to now, there are few studies that use US to evaluate arthritis in small animals (Clavel et al, 2008;Horie et al, 2019;Liao et al, 2016). The recent development of US makes it possible to image more clearly using higher frequencies without motion artifacts.…”