Potential Use of Optical Coherence Tomography and High-Frequency Ultrasound for the Assessment of Nail Disease in Psoriasis and Psoriatic Arthritis
Potential Use of Optical Coherence Tomography and High-Frequency Ultrasound for the Assessment of Nail Disease in Psoriasis and Psoriatic Arthritis
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DOI：
10.1159/000351702
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发表时间：
2013-01-01
期刊：
影响因子：
3.4
通讯作者：
McGonagle, Dennis
中科院分区：
文献类型：
--
作者：
Aydin, Sibel Z.;Castillo-Gallego, Concepcion;McGonagle, Dennis
背景：银屑病指甲疾病越来越被认为是主要的临床和研究相关性。临床评估仍然是目前对其进行评价的金标准。目的：我们比较光学相干断层扫描（OCT）和超声（US）在银屑病甲病变评估中的作用。研究方法：使用OCT扫描18名至少有一个受累指甲的患者和12名健康对照;银屑病患者也进行了US扫描（使用9-14 MHz的线性探头）。记录指甲和轮廓异常。临床甲病评分独立使用修改后的指甲银屑病严重程度指数。结果如下：在180例指甲中，67.8%有临床表现，而33.9%的超声异常和44.4%的OCT异常。阳性OCT的敏感性和特异性分别为44.4%和95.8%，指甲疾病的阳性似然比为10.7。OCT与临床评估的绝对一致率为76.3%，与US的绝对一致率为65%。OCT检测到12例临床正常指甲和41例超声结果正常指甲的细微异常。结论：这些结果表明，OCT具有系统表征银屑病指甲变化的潜力，可用于诊断和更客观地评估治疗反应。(C)2013 S. Karger AG，巴塞尔
Background: Psoriatic nail disease is increasingly recognised to be of major clinical and research relevance. Clinical assessment remains the current gold standard for its evaluation. Objective: We compared optical coherence tomography (OCT) and ultrasound (US) for nail disease assessment in psoriatic disease. Methods: 18 patients with at least one involved nail and 12 healthy controls were scanned using OCT; psoriatic patients also had an US scan (using a linear probe at 9-14 MHz). Nail and contour abnormalities were documented. Clinical onychopathy was scored independently using the modified Nail Psoriasis Severity Index. Results: Among 180 nails, 67.8% had clinical findings whereas 33.9% were abnormal by US and 44.4% had abnormalities on OCT. A positive OCT had a sensitivity and specificity of 44.4 and 95.8%, respectively, with a positive likelihood ratio of 10.7 for nail disease. OCT demonstrated 76.3% absolute agreement compared with clinical assessment and 65% with US. OCT detected subtle abnormalities in 12 clinically normal nails and in 41 nails with normal US findings. Conclusion: These findings show that OCT has a potential for the systematic characterisation of psoriatic nail changes and could be useful in diagnosis and more objective assessment of treatment response. (C) 2013 S. Karger AG, Basel