High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis
High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis
复制标题
DOI：
10.1136/ard.2009.114843
复制
发表时间：
2010-06-01
影响因子：
27.4
通讯作者：
Matucci-Cerinic, Marco
中科院分区：
文献类型：
--
作者：
Kaloudi, Olga;Bandinelli, Francesca;Matucci-Cerinic, Marco
目前，评估系统性硬化症（SSc）的皮肤厚度是通过触诊和使用改良罗德曼皮肤评分（mRSS）进行评估的。目的验证高频超声（US）测量指皮肤厚度的方法是否可靠、可重复性好。方法在70例SSc患者中，由2名观测者在优势肢第二指2个不同部位用US评估皮肤厚度，以确定观测者之间的变异性。第一观察者对患者和对照组进行了两次观察内变异性检查。根据疾病的分期（水肿、纤维化或萎缩）将患者分为三个亚组。结果在两个检查区域，US显示整个SSc患者的皮肤增厚（p < 0.001）。观察者内部和观察者之间的可变性较低。整体mRSS与两个检查部位的局部皮肤厚度之间存在高度显著的相关性（p = 0.032, p = 0.021）。水肿组皮肤厚度显著高于纤维化组（p < 0.001），纤维化组和水肿组皮肤厚度显著高于萎缩组（p < 0.001）。结论超声是一种可靠的工具，结果可重复性好，能够检测出SSc的指指真皮增厚。
Background Currently, assessment of dermal thickness in systemic sclerosis (SSc) is performed by palpation and assessment using the modified Rodnan skin score (mRSS).Objective To verify whether high frequency ultrasound (US) may be a reliable and a reproducible method to measure digital dermal thickness.Methods In 70 patients with SSc, skin thickness was evaluated with US by 2 observers at 2 different sites on the second digit of the dominant limb to determine the interobserver variability. Patients and controls were examined twice by the first observer for intraobserver variability. Patients were divided into three subgroups according to the phase of the disease (oedematous, fibrotic or atrophic).Results At both examined areas, US showed a significant dermal thickening (p < 0.001) in the whole group of patients with SSc. A low intraobserver and interobserver variability was found. A highly significant correlation between the global mRSS and the local dermal thickness at the two examined sites (p = 0.032, p = 0.021) was detected. Skin thickness was significantly higher in the oedematous than in the fibrotic group (p < 0.001) and significantly higher in the fibrotic and the oedematous group (p < 0.001) than in the atrophic group (p < 0.002).Conclusions US is a reliable tool giving reproducible results, and is able to detect digital dermal thickening in SSc.