The value of shear wave elastography in diagnosis and assessment of systemic sclerosis

The aim was to determine the efficacy of shear wave elastography (SWE) in assessing skin stiffness and aiding in the diagnosis of patients with systemic sclerosis (SSc).

A total of 66 patients with SSc, 100 healthy individuals and 27 patients with SSc-like disorders were included. SWE was performed at 17 modified Rodnan skin score (mRSS) measurement sites. The correlation between SWE and clinical profiles was assessed, and the diagnostic value of SSc was explored.

The SWE values at all 17 mRSS sites were significantly higher in SSc than in the healthy group [54.95 (45.95, 66.55) vs 41.10 (39.18, 45.45) m/s, P < 0.001]. For clinically uninvolved sites (mRSS = 0) of patients with SSc, 11 of 17 sites showed significantly higher SWE values compared with healthy controls. SWE was positively correlated with total mRSS (r = 0.783, P < 0.001), the European Scleroderma Study Group disease activity index (r = 0.707, P < 0.001) and histological collagen deposition (r = 0.749, P = 0.013). SWE effectively distinguished patients with SSc from patients with SSc-like disorders (area under the curve, AUC = 0.819). Use of SWE-detected skin sclerosis showed a significantly higher sensitivity compared with 1980 ACR criteria [0.818 (95% CI 0.709, 0.893) vs 0.727 (95% CI 0.610, 0.820), P = 0.031].

SWE correlates well with disease activity and collagen deposition in the skin, provides greater reliability than mRSS and aids in the diagnosis of SSc. SWE could be considered as a convenient and reliable quantitative tool for assessing skin sclerosis and disease progression in SSc.