ObjectiveTo explore the value of two-dimensional ultrasound combined with virtual touch tissue imaging and quantification (VTIQ) in evaluating median nerve injury in rheumatoid arthritis (RA).

MethodsSixty RA patients were selected and divided into active phase (active group) and clinical remission phase (remission group) based on disease activity score (DAS28), with 30 patients in each group, and 30 health examinees during the same period were selected as the control group.The anterior and posterior diameters, cross-sectional areas and shear wave velocities of the median nerve at the wrist joint in the three groups were compared, as well as the correlation with the degree of median nerve injury.The diagnostic efficacy of each indicator was compared through ROC curve analysis.The correlation between shear wave velocity of median nerve and DAS28 was analyzed in RA patients.

ResultsThere were significant differences in the anterior and posterior diameters, cross-sectional areas and shear wave velocities of the median nerve at the wrist joint among the three groups (P < 0.01).The anterior and posterior diameters, cross-sectional areas and shear wave velocities in the active group were significantly greater than those in the remission group and control group (P < 0.01), and the cross-sectional areas and shear wave velocities in the remission group were also significantly greater than those in the control group (P < 0.01).ROC curve analysis showed that the anterior and posterior diameters, cross-sectional areas and shear wave velocities of the median nerve in RA patients had good diagnostic value for median nerve injury.Among them, the diagnostic efficacy of shear wave velocity was the highest, AUC of which was 0.841, and the best cutoff value was 5.075 m/s.The diagnostic efficiency of combined diagnosis of shear wave velocity and cross-sectional area was higher, with an AUC of 0.883.The shear wave velocity of median nerve in active group and remission group was positively correlated with DAS28 (r_s=0.742, 0.393, P < 0.01).

ConclusionsVTIQ can obtain the elastic information of median nerve, and can quantitatively evaluate the median nerve injury in RA patients.The combination of VTIQ and the cross-sectional area of median nerve has higher diagnostic value, which can provide reference for clinical diagnosis and treatment, and prognosis evaluation.