EULAR标准化训练模型超声引导,微创滑膜组织活检程序在大关节和小关节。

IF 5.1 2区 医学 Q1 RHEUMATOLOGY RMD Open Pub Date : 2025-01-20 DOI:10.1136/rmdopen-2024-005065
Ingrid Möller, Raquel Largo, David A Bong, Andrew Filer, Aurélie Najm, Stefano Alivernini, Lene Terslev, Juhani Koski, Peter Balint, George A W Bruyn, Annamaria Iagnocco, Alessandra Bruns, Jacqueline Uson, Carlos Acebes, Ana Rodríguez, Carlos Guillen-Astete, Gabriel Herrero-Beaumont, Maribel Miguel, Jesús Garrido, Maria Antonietta D'Agostino, Esperanza Naredo
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引用次数: 0

摘要

目的:建立超声引导下滑膜组织活检(UG)教育的EULAR培训模式,采用分步方法:(1)制定大关节和小关节滑膜组织活检的教育材料;(2)评估我校尸体标本教学程序的效度、信度和可行性;(3)该方法在活体患者中的验证。方法:采用名义群法(nominal group, NG)和德尔菲共识法(DELPHI consensus methodology),由专家小组制定教育视听资料和UGSTB教育的最低要求。然后,专家们使用开发的方法对尸体关节进行了UGSTB。从尸体关节中提取的样本进行组织学确认,然后由一组具有不同专业知识的超声医师对该程序进行可行性和表面有效性测试。随后,专家们对AV材料和实际程序的阶段进行了排名,以最终确定在患者中实施UGSTB的培训模式。评估患者提取的ST的组织质量。结果:基于NG和DELPHI过程,开发了教材和逐步标准化的基于尸体的培训模型。膝关节是尸体关节,组织学上st质量最好,90%的UGSTB显示滑膜,77%的衬里层完整。结论:这项EULAR的努力提供了一个基于共识的综合教育材料和一个实用的基于尸体的UGSTB培训模型,这在标本和患者的组织获取中显示了可行性和有效性。
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EULAR standardised training model for ultrasound-guided, minimally invasive synovial tissue biopsy procedures in large and small joints.

Objectives: To develop an EULAR training model for education in synovial tissue biopsy (STB) under ultrasound guidance (UG) following a stepwise approach: (1) development of educational material on UGSTB in large and small joints; (2) assessment of the validity, reliability and feasibility of the UGSTB educational procedure on cadaveric specimens; (3) validation of this procedure in live patients.

Methods: Using a nominal group (NG) and a DELPHI consensus methodology, educational audio-visual (AV) material and minimal requirements for education in UGSTB were developed by an expert panel. Then the experts performed an UGSTB on cadaveric joints using the developed approach. The samples retrieved from the cadaveric joints were confirmed histologically and the procedure was then tested by a group of ultrasonographers with different expertise for feasibility and face validity. The AV material and the practical procedures' phases were subsequently ranked by the experts to finalise the training model for performing UGSTB in patients. The ST retrieved in patients was assessed for tissue quality.

Results: Based on NG and DELPHI processes, educational material and a stepwise standardised cadaver-based training model were developed. The knee was the cadaveric joint with the highest yield of histologically good quality of ST. 90% of the UGSTB from patients showed synovial membrane and 77% intact lining layer.

Conclusions: This EULAR endeavour provided a consensus-based comprehensive educational material and a practical cadaver-based model for training in UGSTB, which has shown feasibility and validity in tissue acquisition in specimens and patients.

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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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