ArticleEuropean radiology2026
The value of contrast-enhanced ultrasound in synovial pathotypes of rheumatoid arthritis: an exploratory study.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- From Systemic Autoimmunity to the Local Immune Niche of the Synovium: New Insights into the Development of Rheumatoid Arthritis.Journal of inflammation research · 2026Review
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12 authors.
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Abstract
objectiveTo analyze the differences in contrast-enhanced ultrasound (CEUS) patterns among synovial pathotypes in rheumatoid arthritis (RA), aiming to provide a non-invasive basis for differentiating RA subtypes. MATERIALS AND
methodsA total of 151 patients with RA (involving 151 joints) were included and underwent gray-scale ultrasound, Power Doppler ultrasound (PDUS), CEUS, and ultrasound-guided synovial biopsy sequentially. The synovial tissues were classified into three pathological types by immunohistochemistry, including lympho-myeloid, diffuse-myeloid, and pauci-immune. This study analyzed the differences in ultrasound features among different synovial pathotypes and proposed five distinct synovial vascular enhancement patterns. Variables with correlations > 0.3 were selected to construct three classification models, namely Model 1 (Clinical variables), Model 2 (Clinical-PDUS), and Model 3 (Clinical-PDUS-CEUS).
resultsCEUS synovial vascular enhancement patterns: the pauci-immune predominantly exhibited pattern II (35.7%), the diffuse-myeloid predominantly exhibited pattern IV (42.5%), and the lympho-myeloid predominantly exhibited pattern V (72.0%). Qualitative parameters (enhancement pattern, degree, and range) and quantitative parameters (peak intensity [PI], maximum gradient [MGrad], and wash-out area under the curve [WoAUC]) of CEUS were significantly associated with pathological types (r = 0.426-0.602, all p < 0.001). In differentiating pathological subtypes, Model 3 achieved an AUC of 0.902, which was significantly higher than Model 1 (AUC = 0.728) and Model 2 (AUC = 0.751). However, the diagnostic efficacy for the diffuse-myeloid still needs optimization (AUC = 0.818).
conclusionsCEUS features of synovium can help differentiate RA synovial pathotypes and may provide important guidance for the early diagnosis and treatment selection of RA. KEY POINTS: Question Are there differences between RA synovial pathotype and their corresponding contrast-enhanced (CEUS) findings? Findings Five patterns of synovial vascular enhancement corresponding to pathology types were identified, and a model was constructed. Clinical relevance CEUS synovial qualitative analysis and quantitative parameters can help differentiate RA synovial pathotypes.
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