To analyze the correlation between ultrasound virtual touch tissue imaging and quantification technique (VTIQ) and DAS-28 scores in the clinical diagnosis of hand synovial lesions in patients with rheumatoid arthritis (RA), and to explore the application value of VTIQ technology in evaluating the degree of RA disease activity.

Thirty-two patients clinically diagnosed as RA were selected from the rheumatology Department of the First Affiliated Hospital of Shantou University. Patients meeting the diagnostic criteria for RA were selected, and patients with other rheumatic immune system diseases, other joint diseases, history of joint trauma, and serious diseases that could not cooperate with the examination were excluded. The biochemical index of erythrocyte sedimentation rate (ESR) in RA group was detected, and DAS-28 score was calculated based on clinical history. According to the range of clinical DAS-28 score, RA patients were in two groups: 10 patients with DAS-28 score ≤2.6 were in remission group, and 22 patients with DAS-28 score>2.6 were in active group. The shear wave velocity (SWV) values of the first to fifth metacarpophalangeal joints (MCP) and the thickened synovium of the wrist joints in RA patients with different DAS-28 scores were measured by VTIQ technique to obtain quantitative information of synovium elasticity. The relationship between SWV results and DAS-28 scores was analyzed. The measurement data were consistent with normal distribution using parameter test, while the data were non-normal distribution using non-parametric test Mann-Whitney U test, and Spearman rank correlation analysis was used for correlation study.

There was no statistically significant difference in age and gender between the remission group and the active group (all P>0.05), and all groups were comparable. Synovial scans of 124 joints (124/384) showed satisfactory elastograms, including 87 joints in the active group and 37 joints in the remission group. The SWV values of MCP and wrist joint in the active group were significantly higher than those in the remission group (Z=4.47, 4.43, both P<0.05). The SWV values of MCP and wrist joint were not correlated with age or course of disease (all P>0.05), but was positively correlated with DAS-28 scores(r=0.74, 0.72, both P<0.05).

Synovial SWV values of hand joints in RA patients were positively correlated with DAS-28 scores, suggesting that the VTQI technique can be used as a reference to assess RA disease activity.