High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema, extension and severity in early disease
High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema, extension and severity in early disease
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DOI：
10.1093/rheumatology/kem307
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发表时间：
2008-01-01
期刊：
影响因子：
5.5
通讯作者：
Akesson, A.
中科院分区：
文献类型：
--
作者：
Hesselstrand, R.;Scheja, A.;Akesson, A.
Objective.目的是比较皮肤触诊和高频超声评估与疾病持续时间< 2年的SSc患者。采用20 MHz超声测量106例首次出现非雷诺症状2年内5个不同解剖部位的皮肤厚度和皮肤回声，并与改良Rodnan皮肤评分（mRss）进行比较。病程短的患者的特征是皮肤厚度高和皮肤回声低，两者呈负相关，反映了水肿。与局限性皮肤受累患者相比，弥漫性皮肤受累患者的皮肤厚度更厚，皮肤回声更低。超声测量值与相应解剖区域的局部mRss以及总mRss相关。然而，所有五个解剖部位的不同局部mRss之间的皮肤厚度和皮肤回声都存在相当大的重叠。结论超声检查可较触诊更早发现胸部皮肤受累。在病程较短的SSc患者中，高频超声可以识别可能先于可触及皮肤受累的水肿期，因此可能有助于在疾病过程的早期识别弥漫性皮肤受累的患者。超声测量也反映了整体皮肤受累的严重程度。
Objective. The aim was to compare skin assessment by palpation and by high-frequency ultrasound in patients with SSc with disease duration < 2 yrs.Methods. Skin thickness and skin echogenicity were measured by 20 MHz ultrasound at five different anatomical sites in 106 individuals within 2 yrs from the first non-Raynaud's symptom and compared with the modified Rodnan skin score (mRss).Results. The patients with short disease duration were characterized by high skin thickness and low skin echogenicity, which correlated inversely, reflecting oedema. Patients with diffuse skin involvement displayed higher skin thickness and lower skin echogenicity than did patients with limited skin involvement. The ultrasound measurements correlated to the local mRss from the corresponding anatomical region and also to the total mRss. However, there was a considerable overlap in both skin thickness and skin echogenicity between different local mRss at all five anatomical sites. Skin involvement of the chest could be detected earlier by ultrasound than by palpation.Conclusion. In SSc patients with short disease duration, high-frequency ultrasound can identify the oedematous phase that may precede palpable skin involvement and may thus be useful to identify patients with diffuse skin involvement very early in the disease process. Ultrasound measurements also reflect the severity of the overall skin involvement.