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中华临床医师杂志(电子版) ›› 2025, Vol. 19 ›› Issue (08) : 606 -611. doi: 10.3877/cma.j.issn.1674-0785.2025.08.008

综述

多模态超声及人工智能在细菌性和非细菌性关节炎中应用的研究进展
常芳媛, 乔春梅, 王欣, 王博冉, 赵梓孚, 李春歌, 王晓磊()   
  1. 010110 内蒙古 呼和浩特,内蒙古医科大学附属医院超声科
  • 收稿日期:2025-08-21 出版日期:2025-08-30
  • 通信作者: 王晓磊
  • 基金资助:
    自治区卫生健康委2023年首府地区公立医院高水平临床专科建设科技项目(2023SGGZ052)

Application of multimodal ultrasound and artificial intelligence in distinguishing between bacterial and non-bacterial arthritis

Fangyuan Chang, Chunmei Qiao, Xin Wang, Boran Wang, Zifu Zhao, Chunge Li, Xiaolei Wang()   

  1. Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010110, China
  • Received:2025-08-21 Published:2025-08-30
  • Corresponding author: Xiaolei Wang
引用本文:

常芳媛, 乔春梅, 王欣, 王博冉, 赵梓孚, 李春歌, 王晓磊. 多模态超声及人工智能在细菌性和非细菌性关节炎中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2025, 19(08): 606-611.

Fangyuan Chang, Chunmei Qiao, Xin Wang, Boran Wang, Zifu Zhao, Chunge Li, Xiaolei Wang. Application of multimodal ultrasound and artificial intelligence in distinguishing between bacterial and non-bacterial arthritis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(08): 606-611.

近年来,多模态超声凭借实时动态成像、无放射性、可多关节同步检查等优势,成为关节炎诊疗的重要工具,同时,人工智能与肌骨超声的融合,有效地解决了传统超声在操作可变性、图像解读主观性及数据分析耗时等方面的局限,显著提升了诊断效率与准确性。细菌性关节炎(如化脓性关节炎、布鲁菌病关节炎)与非细菌性关节炎作为关节炎中的两大类,在发病率、治疗、预后均有不同,探讨多模态超声及人工智能在细菌性关节炎与非细菌性关节炎的研究进展与应用前景,可以为临床关节炎的精准诊疗提供参考。

In recent years, multimodal ultrasound has become an important tool for the diagnosis and treatment of arthritis due to its advantages of real-time dynamic imaging, non-radiation, and multi-joint synchronous examination. The integration of artificial intelligence and musculoskeletal ultrasound effectively solves the limitations of traditional ultrasound in terms of operational variability, image interpretation subjectivity, and data analysis time, significantly improving diagnostic efficiency and accuracy. Bacterial arthritis and non-bacterial arthritis, as two major categories of arthritis, are different in incidence rate, treatment, and prognosis. This review aims to explore the research progress and clinical potential of multimodal ultrasound and artificial intelligence in distinguishing between bacterial arthritis and non-bacterial arthritis, in order to provide a reference for improving diagnostic accuracy and guiding treatment decisions.

1
华兴. 肌骨超声的应用现状与发展趋势 [J]. 第三军医大学学报, 2015, 37(20): 2005-2010.
2
周雪添, 马勇, 郭杨, 等. 肌肉骨骼超声技术在骨科诊断治疗中的应用现状及机制 [J]. 中国组织工程研究, 2019, 23(16): 2573-2578.
3
陈梦琳. 急性细菌性关节炎的病原菌特征及药敏实验分析 [J]. 广州医科大学学报, 2021, 49(2): 49-53.
4
Chin TY, Peh WC. Imaging update on musculoskeletal infections [J]. J Clin Orthop Trauma, 2021, 22: 101600.
5
He M, Arthur VD, Pan L, et al. An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review [J]. Front Cell Infect Microbiol, 2023, 13: 1193645.
6
聂丽丽, 崔硬铁. 超声鉴别儿童化脓性关节炎与幼年特发性关节炎的临床价值 [J]. 临床超声医学杂志, 2024, 26(4): 291-295.
7
孙昇, 王强. 小儿急性化脓性髋关节炎的诊疗进展 [J]. 世界临床药物, 2020, 41(9): 727-732.
8
栾志勇, 高凤奇, 姚大陆, 等. 超声引导下微创治疗儿童化脓性髋关节炎10例 [J]. 临床小儿外科杂志, 2021, 20(5): 469-473.
9
敏超. 布鲁氏菌病性关节炎的超声影像学研究 [D]. 呼和浩特: 内蒙古医科大学, 2024.
10
房玉萍, 张立波. 布鲁菌病性骨关节炎研究进展 [J]. 中华地方病学杂志, 2019, 38(5): 426-430.
11
Morovati S, Bozorgomid A, Mohammadi A, et al. Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features [J]. Ther Adv Infect Dis, 2024, 11: 20499361241246937.
12
王登芹, 赵会丽, 张茜茜, 等. 布鲁氏菌病合并骨关节炎患者临床特征分析 [J]. 中华地方病学杂志, 2024, 43(2): 137-140.
13
Chen J, Zhi F, Zhao G, et al. Brucella osteoarthritis: recent progress and future directions[J]. Front Microbiol, 2025, 16:1522537.
14
王猛, 姚五平, 柳直, 等. 关节镜辅助下关节腔滑膜清理术治疗布鲁氏菌感染后单侧膝骨关节炎2例报道 [J]. 中华骨与关节外科杂志, 2025, 18(3): 286-288.
15
Turan H, Serefhanoglu K, Karadeli E, et al. A case of brucellosis with abscess of the iliacus muscle, olecranon bursitis, and sacroiliitis [J]. Int J Infect Dis, 2009, 13(6): e485-e487.
16
陈丰哲, 程凯, 李安宁, 等. 1例骶髂关节型布鲁氏菌病并文献复习 [J]. 复旦学报(医学版), 2018, 45(2): 277-280.
17
皮晓雨, 王浩, 梁晨, 等. 14例布鲁氏菌病性胸锁关节炎患者临床特点 [J]. 中国感染控制杂志, 2023, 22(9): 1058-1064.
18
Odeh A, Alkhaled F, Soudi S. Unraveling a complex case: Brucellosis manifesting as fever of unknown origin, septic ankle arthritis, and iliacus abscess [J]. Cureus, 2024, 16(11): e74147.
19
Zhang W, Zhang Y, Wang J, et al. Recurrent arthritis caused by brucella melitensis in a Chinese adult: a case report [J]. Infect Drug Resist, 2022, 15: 7235-7240.
20
AI Hariri B, Zuhair M, Nashwan AJ. Brucellosis unusually presented as septic knee arthritis: a case report [J]. Clin Case Rep, 2022, 10(10): e6461.
21
程玉谦, 王一奇, 杨惠芬. 表现为发热伴胸锁关节痛的布鲁菌病1例 [J]. 中国临床案例成果数据库, 2024, 6(1): E1272.
22
李巧凤, 蒋俊杰, 曾鸽, 等. 滑膜超声造影在类风湿关节炎患者诊断及疗效评估中的应用价值[J]. 中国超声医学杂志, 2022, 38(10): 1178-1182.
23
Brown P, Pratt AG, Hyrich KL. Therapeutic advances in rheumatoid arthritis [J]. BMJ, 2024, 384: e70856.
24
王瑞, 孙魏巍, 艾娇, 等. 临床前期类风湿关节炎的特点及治疗策略 [J/OL]. 中华临床医师杂志(电子版), 2018, 12(8): 472-476.
25
王友, 王远勤. 肌骨超声在早期类风湿性关节炎指关节病变中的诊断价值分析 [J]. 影像研究与医学应用, 2022, 6(22): 44-46.
26
陈斐臻. 肌骨超声在血清阴性类风湿关节炎中的诊断价值研究 [J]. 现代医用影像学, 2022, 31(12): 2328-2330.
27
Cen Y, He D, Wang P, et al. Contribution of musculoskeletal ultrasound in the diagnosis of seronegative rheumatoid arthritis [J]. J Ultrasound Med, 2024, 43(10): 1929-1936.
28
王博冉, 乔春梅, 李春歌, 等. 多模态超声检查技术及超声评分方法在类风湿性关节炎中的应用 [J/OL]. 中华医学超声杂志(电子版), 2021, 18(3): 330-333.
29
Polido-Pereira J, António MS, Khmelinskii N, et al. Contrast-enhanced ultrasound as a valuable tool to detect minimal inflammation in RA patients in sustained remission [J]. Front Med (Lausanne), 2024, 11: 1459802.
30
王紫艺, 陈笑一, 张双双, 等. 超微血管成像用于肌肉骨骼疾病研究进展 [J]. 中国医学影像技术, 2024, 40(2): 298-301.
31
刘芳, 朱家安, 魏小雨, 等. 超微血流成像技术评估类风湿关节炎患者手指关节亚临床炎 [J]. 中国医学影像技术, 2016, 32(5): 663-666.
32
李丽, 叶玉泉, 陈京京, 等. 超微血管成像技术评估类风湿活动性关节炎:与CDFI和CEUS对比 [J]. 中国医学影像技术, 2016, 32(10): 1569-1571.
33
邱跃文, 金林原, 张艳芬, 等. 彩色超微血管成像在类风湿关节炎治疗中的应用价值 [J]. 临床超声医学杂志, 2021, 23(7): 556-559.
34
曾鸽, 蒋俊杰, 孙婞, 等. 微血流成像和超声造影对类风湿性关节炎患者病情及滑膜血流评估的一致性分析 [J]. 中华全科医学, 2024, 22(4): 638-641.
35
叶晶晶, 熊超芳, 黄晓民. 超声鉴别诊断痛风性关节炎与焦磷酸钙沉积病 [J]. 中国医学影像技术, 2023, 39(7): 1060-1064.
36
Yan M, Du M, Yu T, et al. Concordance of ultrasound and dual-energy CT in diagnosing gouty arthritis in the knee joint: a retrospective observational study [J]. Acad Radiol, 2025, 32(1): 316-325.
37
Deng SH, Dang WT, Liu J, et al. Differential diagnosis of acute and chronic gouty arthritis by multijoint ultrasound [J]. Ultrasound Med Biol, 2021, 47(10): 2853-2859.
38
Lin M, Yan L, He M, et al. Development and validation of an ultrasound-based clinical radiomics nomogram for diagnosing gouty arthritis [J]. Ultrasound Med Biol, 2025, 51(4): 650-660.
39
Sconfienza LM, Albano D, Allen G, et al. Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus [J]. Eur Radiol, 2018, 28(12): 5338-5351.
40
Otter S, Payne C, Jones AM, et al. Differences in achilles tendon stiffness in people with gout: a pilot study [J]. BMC Musculoskelet Disord, 2020, 21(1): 658.
41
Tang Y, Yan F, Yang Y, et al. Value of shear wave elastography in the diagnosis of gouty and non-gouty arthritis [J]. Ultrasound Med Biol, 2017, 43(5): 884-892.
42
唐一植, 靳丽嘉. 高频超声介入治疗风湿性关节炎的疗效分析 [J]. 中国现代医学杂志, 2021, 31(18): 23-27.
43
Dağıstan G, Gönüllü E. Ultrasound vs. fluoroscopic guidance in genicular nerve radiofrequency thermocoagulation for chronic knee pain: which one is the future? [J]. Eur Rev Med Pharmacol Sci, 2023, 27(15): 7073-7080.
44
Favero M, Belluzzi E, Ortolan A, et al. Erosive hand osteoarthritis: latest findings and outlook [J]. Nat Rev Rheumatol, 2022, 18(3): 171-183.
45
刘合潮, 乔鹏燕, 张莉芸, 等. 超声在骨关节炎中的应用研究进展 [J]. 中华风湿病学杂志, 2022, 26(7): 496-500.
46
Nevalainen MT, Uusimaa AP, Saarakkala S. The ultrasound assessment of osteoarthritis: the current status [J]. Skeletal Radiol, 2023, 52(11): 2271-2282.
47
Nelson AE. Turning the page in osteoarthritis assessment with the use of ultrasound [J]. Curr Rheumatol Rep, 2020, 22(10): 66.
48
Murakami T, Enokida M, Kawaguchi K, et al. Useful ultrasonographic evaluation of the medial meniscus as a feature predicting the onset of radiographic knee osteoarthritis [J]. J Orthop Sci, 2017, 22(2): 318-324.
49
Bean MB, Favero M, Ramonda R, et al. Erosive hand osteoarthritis: recent advances and future treatments [J]. Curr Rheumatol Rep, 2024, 26(4): 103-111.
50
吕白雪, 项飞翔, 李玉曼, 等. 剪切波弹性成像在肌腱肌肉病变中的应用进展 [J]. 中国医师杂志, 2021, 23(4): 484-487.
51
Shams M, Karimi N, Vahedi M, et al. Reliability of muscle stiffness measures in popliteus, medial and lateral gastrocnemius muscles by ultrasound shear wave elastography in participants with knee osteoarthritis accompanied by myofascial trigger points [J]. BMC Musculoskelet Disord, 2024, 25(1): 221.
52
Yokus A, Toprak M, Arslan H, et al. Evaluation of distal femoral cartilage by B-mode ultrasonography and shear wave elastography in patients with knee osteoarthritis: a preliminary study [J]. Acta Radiol, 2021, 62(4): 510-514.
53
Zhang H, Ning E, Lu L, et al. Research progress of ultrasound in accurate evaluation of cartilage injury in osteoarthritis [J]. Front Endocrinol (Lausanne), 2024, 15: 1420049.
54
富丽萍, 袁立霞, 王杰, 等. 近十年低强度脉冲超声在肌骨疾病治疗中的应用进展 [J]. 南方医科大学学报, 2025, 45(3): 661-668.
55
Okano T, Mamoto K, Di Carlo M, et al. Clinical utility and potential of ultrasound in osteoarthritis [J]. Radiol Med, 2019, 124(11): 1101-1111.
56
Olivas-Vergara O, Martinez-Estupinan L, Romero-Bueno F, et al. Value of ultrasound-assessed dactylitis in the early diagnosis of psoriatic arthritis [J]. Semin Arthritis Rheum, 2025, 70: 152612.
57
Ribeiro AL, Eder L. From psoriasis to psoriatic arthritis: ultrasound insights connecting psoriasis with subclinical musculoskeletal inflammation and the path to psoriatic arthritis [J]. Curr Rheumatol Rep, 2024, 26(7): 235-247.
58
Tom S, Zhong Y, Cook R, et al. Development of a preliminary ultrasonographic enthesitis score in psoriatic arthritis - GRAPPA ultrasound working group [J]. J Rheumatol, 2019, 46(4): 384-390.
59
Gudu T, Ng B, Jethwa H, et al. Improving imaging modalities in early psoriatic arthritis: the role of ultrasound in early diagnosis of psoriatic arthritis [J]. Front Med (Lausanne), 2021, 8: 804695.
60
Sapundzhieva T, Karalilova R, Batalov A. Hand ultrasound patterns in rheumatoid and psoriatic arthritis: the role of ultrasound in the differential diagnosis [J]. Rheumatol Int, 2020, 40(6): 837-848.
61
Gitto S, Serpi F, Albano D, et al. AI applications in musculoskeletal imaging: a narrative review [J]. Eur Radiol Exp, 2024, 8(1): 22.
62
Getzmann JM, Zantonelli G, Messina C, et al. The use of artificial intelligence in musculoskeletal ultrasound: a systematic review of the literature [J]. Radiol Med, 2024, 129(9): 1405-1411.
63
Andersen J, Pedersen JS, Laursen MS, et al. Neural networks for automatic scoring of arthritis disease activity on ultrasound images [J]. RMD Open, 2019, 5(1): e891.
64
He X, Wang M, Zhao C, et al. Deep learning-based automatic scoring models for the disease activity of rheumatoid arthritis based on multimodal ultrasound images [J]. Rheumatology (Oxford), 2024, 63(3): 866-873.
65
Overgaard BS, Christensen A, Terslev L, et al. Artificial intelligence model for segmentation and severity scoring of osteophytes in hand osteoarthritis on ultrasound images [J]. Front Med (Lausanne), 2024, 11: 1297088.
66
du Toit C, Orlando N, Papernick S, et al. Automatic femoral articular cartilage segmentation using deep learning in three-dimensional ultrasound images of the knee [J]. Osteoarthr Cartil Open, 2022, 4(3): 100290.
67
Tiulpin A, Saarakkala S, Mathiessen A, et al. Predicting total knee arthroplasty from ultrasonography using machine learning [J]. Osteoarthr Cartil Open, 2022, 4(4): 100319.
68
于海涛, 吴昊越, 张浩强, 等. 人工智能在膝骨关节炎诊疗中的应用进展 [J]. 解放军医学杂志, 2025, 50(1): 9-15.
69
Yi PH, Garner HW, Hirschmann A, et al. Clinical applications, challenges, and recommendations for artificial intelligence in musculoskeletal and soft-tissue ultrasound: AJR expert panel narrative review [J]. AJR Am J Roentgenol, 2024, 222(3): e2329530.
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[15] 薛怡宁, 兰雅迪, 刘兆宇, 史磊, 赵琪, 许洪伟. 基于图像的人工智能在胃癌中的研究进展[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(06): 670-675.
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