{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:07:05Z","timestamp":1788311225875,"version":"build-2803163510"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown etiology that causes progressive and destructive inflammation in the joints. Superb microvascular imaging (SMI) is a new ultrasound technique that allows visualization of slow blood flow in synovitis. This study aimed to report on the clinical value and utility of the SMI technique and its grading for monitoring RA by determining the correlation with clinical disease activity scores (DAS 28) and power Doppler ultrasound (PDUS).<\/jats:p><jats:p>All RA patients with clinically apparent synovitis were assessed using DAS 28. Synovitis was investigated with PDUS and SMI and each joint was graded semi-quantitatively. All assessments were carried out at baseline and repeated at least at the 4-month follow-up. Correlations between scores were investigated using Spearman\u2019s correlation.<\/jats:p><jats:p>60 RA patients with 552 affected joints were recruited. Clinical and sonographic scores were significantly improved at follow-up (p&lt;0.001). SMI showed significantly more joint count and flow signal scores than clinical examination and PDUS. Moderate correlations were found between the SMI score and clinical scores (p&lt;0.001, 0.586 for SMI score vs. DAS 28-CRP, p=0.001, 0.432 for SMI vs. DAS 28-ESR). There were also stronger correlations between the SMI score and PDUS score at both baseline and follow-up (p&lt;0.001, r = 0.817, 0.842 respectively).<\/jats:p><jats:p>SMI provides greater utility and ability to detect synovial vascularity and to monitor disease activity than PDUS. A new activity scoring system based on SMI and clinical objective findings is required to improve reliability and validity.<\/jats:p>","DOI":"10.1055\/a-2463-8297","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T20:10:17Z","timestamp":1731010217000},"page":"388-395","source":"Crossref","is-referenced-by-count":9,"title":["The reliability and validity of superb microvascular imaging as a potential disease activity marker in rheumatoid arthritis"],"prefix":"10.1055","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6046-3486","authenticated-orcid":false,"given":"Esin","family":"Kurtulus Ozturk","sequence":"additional","affiliation":[{"name":"Radiology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saffet","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Radiology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse Bahar","family":"Kelesoglu Dincer","sequence":"additional","affiliation":[{"name":"Rheumatology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"JS Smolen","year":"2016","journal-title":"Lancet"},{"issue":"11","key":"ref2","doi-asserted-by":"publisher","DOI":"10.3390\/cells10112857","article-title":"Management of Rheumatoid Arthritis: An Overview","volume":"10","author":"AF Radu","year":"2021","journal-title":"Cells"},{"issue":"03","key":"ref3","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1136\/ard.2004.023929","article-title":"Assessment of inflammatory activity in rheumatoid arthritis: a 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synovitis: does it need an update?","volume":"54","author":"WA Schmidt","year":"2015","journal-title":"Rheumatology (Oxford)"},{"issue":"06","key":"ref7","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1159\/000493390","article-title":"Rheumatoid Arthritis: A Brief Overview of the Treatment","volume":"27","author":"J Bullock","year":"2018","journal-title":"Med Princ Pract"},{"issue":"S 05","key":"ref8","first-page":"S40","article-title":"The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS-28) in the management of rheumatoid arthritis","volume":"34","author":"PL van Riel","year":"2016","journal-title":"Clin Exp Rheumatol"},{"issue":"02","key":"ref9","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/RHU.0000000000000469","article-title":"The Reliability of Disease Activity Score in 28 Joints-C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters: A Cross-sectional, Exploratory Study","volume":"23","author":"IM Jensen Hansen","year":"2017","journal-title":"J Clin Rheumatol"},{"issue":"06","key":"ref10","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1007\/s10067-017-3628-3","article-title":"Contribution of subjective Disease Activity Score 28 (DAS-28) components to the response to treatment of rheumatoid arthritis","volume":"36","author":"KM Son","year":"2017","journal-title":"Clin Rheumatol"},{"issue":"05","key":"ref11","first-page":"966","article-title":"Ultrasonography is superior to clinical examination in the detection and localization of knee joint effusion in rheumatoid arthritis","volume":"30","author":"D Kane","year":"2003","journal-title":"J Rheumatol"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1002\/1529-0131(200109)44:9<2018::AID-ART350>3.0.CO;2-C","article-title":"Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging","volume":"44","author":"M Szkudlarek","year":"2001","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref13","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1002\/art.10877","article-title":"Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis","volume":"48","author":"M Szkudlarek","year":"2003","journal-title":"Arthritis Rheum"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"325909","DOI":"10.1155\/2015\/325909","article-title":"The Role of Power Doppler Ultrasonography as Disease Activity Marker in Rheumatoid Arthritis","volume":"2015","author":"S Bhasin","year":"2015","journal-title":"Dis Markers"},{"issue":"03","key":"ref15","doi-asserted-by":"publisher","first-page":"118","DOI":"10.5152\/eurjrheum.2020.20038","article-title":"Analysis of the correlation between disease activity score 28 and its ultrasonographic equivalent in rheumatoid arthritis patients","volume":"7","author":"R Coras","year":"2020","journal-title":"Eur J Rheumatol"},{"issue":"37","key":"ref16","doi-asserted-by":"publisher","first-page":"e22185","DOI":"10.1097\/MD.0000000000022185","article-title":"Superb microvascular imaging evaluating joint lesion scores in rheumatoid arthritis compared with power Doppler imaging: A meta-analysis","volume":"99","author":"M Lin","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"ref17","first-page":"19930","article-title":"Superb Micro-Vascular Imaging improving inflammatory flow blood sensitivity in patients with rheumatoid arthritis","volume":"9","author":"W Li","year":"2016","journal-title":"Int J Clin Exp Med"},{"issue":"03","key":"ref18","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1007\/s00330-017-5016-4","article-title":"Microflow imaging: New Doppler technology to detect low-grade inflammation in patients with arthritis","volume":"28","author":"AKP 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