Validation of thermography in the diagnosis of reflex sympathetic dystrophy
Validation of thermography in the diagnosis of reflex sympathetic dystrophy
复制标题
DOI：
10.1097/00002508-199612000-00011
复制
发表时间：
1996-12-01
影响因子：
2.9
通讯作者：
Ivankovich, O
中科院分区：
文献类型：
--
作者：
Bruehl, S;Lubenow, TR;Ivankovich, O
目的：为了检查在反射性交感神经营养不良（RSD）的诊断中自主神经功能的几个热像图衍生指数的有效性，设计：一系列慢性疼痛患者基于热像图结果使用判别函数分析和有效性测量（例如，灵敏度，特异性）用于确定计算机化热像像素分析在区分RSD与其他病理学中的准确性。设置：该研究在Rush疼痛中心进行，该中心是一个多学科门诊疼痛诊所。患者：一系列46名慢性疼痛患者因怀疑交感神经介导的疼痛而被转诊。干预措施：所有患者在适应气候控制室后在基线条件下接受计算机热成像检查，在对侧未受累肢体施加冷刺激后立即（4 ℃，90秒）和冷刺激后20分钟。测量三个实验期间的温度、三个期间患肢和非患肢之间的温度不对称程度、对冷刺激的反应以及冷刺激后的恢复。温度不对称准确区分RSD和非RSD患者，在基线时获得最准确的不对称测量。冷挑战和实际温度值的反应没有区分RSD和非RSD pain patients.Conclusions：热成像可以是一个有用的组成部分，RSD诊断。在灵敏度和特异性同等重要的情况下，0.6 ℃的不对称截止值似乎是最佳的。如果特异性（即，准确地排除非RSD情况）更重要，也可以考虑0.8摄氏度或1.0摄氏度的截止值。
Objectives: To examine the validity of several thermogram-derived indices of autonomic functioning in the diagnosis of reflex sympathetic dystrophy (RSD).Design: A series of chronic pain patients were classified diagnostically based on thermogram results using discriminant function analysis, and validity measures (e.g., sensitivity, specificity) were used to determine the accuracy of computerized thermographic pixel analysis in discriminating RSD from other pathology.Setting: The study was conducted at the Rush Pain Center, a multidisciplinary outpatient pain clinic.Patients: A series of 46 chronic pain patients referred for suspected sympathetically mediated pain.Interventions: All patients underwent computerized thermographic examination under a baseline condition after acclimating to a climate-controlled room, immediately after a cold challenge was applied to the contralateral uninvolved extremity (4 degrees C for 90 s) and 20 min after the cold challenge.Outcome Measures: Temperature during the three experimental periods, degree of temperature asymmetry between affected and nonaffected limbs during the three periods, response to cold challenge, and recovery following cold challenge were measured.Results: Temperature asymmetry accurately discriminated between RSD and non-RSD patients, with the most accurate asymmetry measures obtained at baseline. Responses to cold challenge and actual temperature values did not discriminate between RSD and non-RSD pain patients.Conclusions: Thermography can be a useful component of RSD diagnosis. In situations where sensitivity and specificity are equally important, an asymmetry cutoff of 0.6 degrees C appears optimal. If specificity (i.e., accurately ruling out non-RSD cases) is more important, a cutoff of 0.8 degrees C or 1.0 degrees C may be considered as well.