基于剪切波弹性图的系统性硬化症皮肤评估系统:作为传统超声波的补充或替代?
Yujia Yang1, Xinyi Tang1, Lin Zhong1
1Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China.
Quantitative imaging in medicine and surgery
|July 17, 2023
概括
剪切波弹性图 (SWE) 在区分系统性硬化症 (SSc) 亚型方面显示出比高频超声波 (HFUS) 更高的准确性. SWE受临床因素的影响较小,并提供更好的皮肤严重性歧视,将其定位为主要的成像工具.
科学领域:
- 类风湿病学 类风湿病学
- 医疗成像医学成像
- 生物物理学的生物物理.
背景情况:
- 系统性硬化症 (SSc) 的诊断和监测依赖于评估皮肤参与.
- 目前的成像技术,如高频超声波 (HFUS) 测量皮肤厚度,但在区分SSc亚型和评估疾病严重程度方面存在局限性.
- 剪波弹性图 (SWE) 显示出在SSc中评估皮肤硬性的前景,但其比较有效性和最佳应用部位需要进一步调查.
研究的目的:
- 为了比较基于SWE的皮肤硬度和基于HFUS的皮肤厚度的诊断性能,在区分有限和扩散的SSc亚型时.
- 调查临床特征对各种身体部位的HFUS和SWE测量的影响.
- 确定最佳的成像部位和评估SSc皮肤干扰的方法.
主要方法:
- 一项前性研究包括49名有限和51名扩散SSc患者.
- 在17个部位进行了皮肤评估,使用触摸 (改性罗丹皮肤评分 - mRSS),HFUS用于皮肤厚度,SWE用于皮肤硬.
- 收集了包括年龄,性别,体重指数和疾病持续时间在内的临床数据.
主要成果:
- 与有限的SSc患者相比,分散的SSc患者在大多数评估部位表现出明显更高的皮肤硬度和厚度 (P<0.05).
- HFUS和SWE的组合实现了区分SSc亚型的0.973曲线下的最高面积 (AUC),单独优于HFUS (0.866) 和SWE (0.921).
- 与HFUS相比,SWE与临床特征的变异性较小,在多个部位的不同mRSS值之间有更好的区别.
结论:
- 剪切波弹性图 (SWE) 与HFUS在评估SSc皮肤方面具有显著的优势,包括减少临床因素的影响和提高在区分疾病严重性的敏感性.
- SWE有可能成为系统性硬化皮肤表现的初级成像评估工具,在某些应用中补充或可能取代HFUS.
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