Dermatology Research Centre, The University of Queensland, School of Medicine, Queensland, Australia.
Australas J Dermatol. 2011 May;52(2):89-97. doi: 10.1111/j.1440-0960.2011.00756.x.
BACKGROUND/OBJECTIVES: Reflectance confocal microscopy (RCM) is a non-invasive method of imaging human skin in vivo. The purpose of this study was to observe the experience of using RCM on equivocal skin lesions in a tertiary clinical setting in Queensland.
Fifty equivocal lesions on 42 patients were imaged using a reflectance confocal microscope immediately prior to being excised. The images were then analysed blind to the histopathological diagnosis. The experience and problems encountered when using RCM on skin lesions for the first time was also observed.
On RCM analysis 12/13 melanomas (92.3% sensitivity, 75% specificity), 19/22 benign naevi (86% sensitivity, 95% specificity), 6/9 basal cell carcinomas (66.7% sensitivity, 100% specificity)and 6/6 squamous cell carcinomas and its precursors (100% sensitivity, 75% specificity) were diagnosed correctly when using histology as the gold standard. We identified three common problems that affected image quality: object artefacts; positioning artefacts; and movement artefacts.
Using simple techniques we found that common RCM features were readily identifiable and common artefacts could be minimized, making RCM a useful tool to aid the diagnosis of equivocal skin lesions in a clinical setting.
背景/目的：反射共聚焦显微镜（RCM）是一种对人体皮肤进行非侵入性活体成像的方法。本研究的目的是观察在昆士兰州的三级临床环境中对疑似皮肤病变使用 RCM 的经验。
对 42 名患者的 50 个疑似病变在进行切除之前立即使用反射共聚焦显微镜进行成像。然后，将这些图像进行盲法分析，而不考虑组织病理学诊断。还观察了首次在皮肤病变上使用 RCM 时的经验和遇到的问题。
在 RCM 分析中，当以组织学为金标准时，12/13 例黑色素瘤（92.3%的敏感性，75%的特异性）、19/22 例良性痣（86%的敏感性，95%的特异性）、6/9 例基底细胞癌（66.7%的敏感性，100%的特异性）和 6/6 例鳞状细胞癌及其前体（100%的敏感性，75%的特异性）被正确诊断。我们发现了三个常见的影响图像质量的问题：物体伪影；定位伪影；和运动伪影。
通过使用简单的技术，我们发现常见的 RCM 特征易于识别，常见的伪影可以最小化，使 RCM 成为一种有用的工具，有助于在临床环境中诊断疑似皮肤病变。
