Nailfold Microvascular Imaging by Dynamic Optical Coherence Tomography in Systemic Sclerosis: A Case-Controlled Pilot Study
Nailfold Microvascular Imaging by Dynamic Optical Coherence Tomography in Systemic Sclerosis: A Case-Controlled Pilot Study
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DOI：
10.1016/j.jid.2021.08.436
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发表时间：
2022-03-21
影响因子：
6.5
通讯作者：
Del Galdo, Francesco
中科院分区：
文献类型：
--
作者：
Abignano, Giuseppina;Green, Lorraine;Del Galdo, Francesco
在系统性硬化症中，皮肤微血管病变的结果测量需要临床试验和实践。本研究的目的是确定动态光学相干断层扫描（D-OCT）是否能够提供微血管病变的信息相比，目前的金标准，甲襞视频毛细血管镜检查（NVC），在系统性硬化症患者。该病例对照研究包括（i）40例系统性硬化症患者，按NVC模式分为4个年龄和性别匹配组（正常/非特异性、早期、活动性、晚期）;（ii）第五组10例年龄和性别匹配的健康对照。所有受试者均接受了NVC和D-OCT检查，并将D-OCT图像与相应的NVC图像进行比较。评估了可靠性。D-OCT图像显示了相应的NVC模式。5个NVC模式组的D-OCT微血管血流密度不同（P = 0.0114），具有显著趋势检验（P = 0.0006）。微血管血流密度与NVC半定量评分（r =-0.7，P = 0.0001）、每mm异常形状数（r = 0.3，P = 0.0264）和每mm毛细血管数（r = 0.6，P = 0.0001）相关。可靠性极佳（组内相关系数> 0.9）。总之，在系统性硬化症患者中，D-OCT提供了甲襞微血管病变的定性和定量信息，显示了微血管血流密度与NVC评分之间的相关性。D-OCT作为一种标准化的成像技术的发展可以在临床试验和实践中提供定量的结果测量。
In systemic sclerosis, outcome measures of skin microvasculopathy are needed for both clinical trials and practice. The aim of this study was to determine whether dynamic-optical coherence tomography (D-OCT) is able to provide information on microvasculopathy compared with the current gold standard, nailfold video-capillaroscopy (NVC), in patients with systemic sclerosis. This case-controlled study included (i) 40 patients with systemic sclerosis, classified by NVC pattern in four age- and sex-matched groups (normal/nonspecific, early, active, late); (ii) a fifth group of 10 age- and sex-matched healthy controls. All participants underwent NVC and D-OCT. D-OCT images were compared with the corresponding NVC images. Reliability was assessed. D-OCT images visualized the corresponding NVC patterns. D-OCT microvascular flow density was different across the five NVC pattern groups (P = 0.0114) with a significant trend test (P = 0.0006). Microvascular flow density correlated with the NVC semiquantitative score (r = -0.7, P < 0.0001), number of abnormal shapes/mm (r = .0.3, P = 0.0264), and number of capillaries/mm (r = 0.6, P < 0.0001). Reliability was excellent (intraclass correlation coefficient > 0.9). In conclusion, in patients with systemic sclerosis, D-OCT provided qualitative and quantitative information on nailfold microvasculopathy, showing a correlation between microvascular flow density and NVC scores. The development of D-OCT as a standardized imaging technique could provide a quantitative outcome measure in clinical trials and practice.