Huygen Frank J P M, Niehof Sjoerd, Klein Jan, Zijlstra Freek J
Department of Anesthesiology, Pain Treatment Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Eur J Appl Physiol. 2004 May;91(5-6):516-24. doi: 10.1007/s00421-003-1037-6. Epub 2004 Jan 21.
The use of thermography in the diagnosis and evaluation of complex regional pain syndrome type 1 (CRPS1) is based on the presence of temperature asymmetries between the involved area of the extremity and the corresponding area of the uninvolved extremity. The interpretation of thermographic images is, however, subjective and not validated for routine use. The objective of the present study was to develop a sensitive, specific and reproducible arithmetical model as the result of computer-assisted infrared thermography in patients with early stage CRPS1 in one hand. Eighteen patients with CRPS1 on one hand and 13 healthy volunteers were included in the study. The severity of the disease was determined by means of pain questionnaires [visual analogue scale (VAS) pain and McGill Pain Questionnaire], measurements of mobility (active range of motion) and oedema volume. Asymmetry between the involved and the uninvolved extremities was calculated by means of the asymmetry factor, the ratio and the average temperature differences. The discrimination power of the three methods was determined by the receiver-operating curve (ROC). The regression between the determined temperature distributions of both extremities was plotted. Subsequently the correlation of the data was calculated. In normal healthy individuals the asymmetry factor was 0.91 (0.01) (SD), whereas in CRPS1 patients this factor was 0.45 (0.07) (SD). The performance of the arithmetic model based on the ROC curve was excellent. The area under the curve was 0.97, the P value was <0.001, the sensitivity 92% and specificity 94%. Furthermore, the temperature asymmetry factor was correlated with the duration of the disease and VAS pain. In conclusion, in resting condition, videothermography is a reliable additive diagnostic tool of early stage CRPS1. This objective tool could be used for monitoring purposes during experimental therapeutic intervention.
热成像技术在1型复杂性区域疼痛综合征（CRPS1）的诊断和评估中的应用基于患侧肢体受累区域与未受累肢体相应区域之间存在温度不对称性。然而，热成像图像的解读具有主观性，且未经验证可用于常规用途。本研究的目的是开发一种敏感、特异且可重复的算术模型，该模型是通过计算机辅助红外热成像技术对单侧早期CRPS1患者进行研究的结果。本研究纳入了18名单侧患有CRPS1的患者和13名健康志愿者。通过疼痛问卷[视觉模拟评分法（VAS）疼痛评分和麦吉尔疼痛问卷]、活动度测量（主动活动范围）和水肿体积来确定疾病的严重程度。通过不对称因子、比率和平均温度差来计算患侧和未患侧肢体之间的不对称性。通过受试者操作特征曲线（ROC）来确定这三种方法的鉴别能力。绘制两侧肢体确定的温度分布之间的回归曲线。随后计算数据的相关性。在正常健康个体中，不对称因子为0.91（0.01）（标准差），而在CRPS1患者中，该因子为0.45（0.07）（标准差）。基于ROC曲线的算术模型表现出色。曲线下面积为0.97，P值<0.001，灵敏度为92%，特异性为94%。此外，温度不对称因子与疾病持续时间和VAS疼痛评分相关。总之，在静息状态下，视频热成像技术是早期CRPS1可靠的辅助诊断工具。这种客观工具可用于实验性治疗干预期间的监测目的。
