Hou Yong, Zhu Qing-Li, Liu He, Jiang Yu-Xin, Wang Liang, Xu Dong, Li Meng-Tao, Zeng Xiao-Feng, Zhang Feng-Chun
From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
J Rheumatol. 2015 Mar;42(3):449-55. doi: 10.3899/jrheum.140873. Epub 2015 Jan 15.
To investigate skin elasticity using acoustic radiation force impulse (ARFI) quantification in systemic sclerosis (SSc), and compare the modified Rodnan skin score (mRSS) with measured shear wave velocity (SWV) and thickness of the skin.
Fifteen patients with diffuse cutaneous SSc (dcSSc) and 15 age-matched and sex-matched healthy controls were evaluated. The SWV and thickness of skin were measured at 17 sites corresponding to those assessed in the mRSS in each participant. The SWV measurements of skin were compared between patients with dcSSc and healthy controls. The correlations between the mRSS and the skin SWV and thickness were explored using Spearman's correlation.
The SWV values were higher in patients with dcSSc compared with healthy controls at right hand dorsum, right forearm, left hand dorsum, left forearm, right foot dorsum, and left foot dorsum (p < 0.05). In patients with dcSSc, the SWV values of uninvolved skin were higher than those of controls (p < 0.001), and the SWV values increased with increasing skin scores except for skin score 3 (p < 0.05). The sum of the SWV values correlated with total clinical skin score (r = 0.841, p < 0.001), and the sum of the skin thickness correlated with total clinical skin score (r = 0.740, p = 0.002).
ARFI quantification is feasible and reliable for assessing the skin involvement in dcSSc. ARFI quantification could identify early skin change that may precede palpable skin involvement, and may be a valuable adjunct to skin evaluation in patients with SSc.
利用声辐射力脉冲（ARFI）定量技术研究系统性硬化症（SSc）患者的皮肤弹性，并比较改良Rodnan皮肤评分（mRSS）与测量得到的剪切波速度（SWV）及皮肤厚度。
对15例弥漫性皮肤型SSc（dcSSc）患者和15例年龄及性别匹配的健康对照者进行评估。在每位参与者对应于mRSS评估部位的17个位点测量皮肤的SWV和厚度。比较dcSSc患者与健康对照者的皮肤SWV测量值。采用Spearman相关性分析探索mRSS与皮肤SWV及厚度之间的相关性。
dcSSc患者右手背、右前臂、左手背、左前臂、右脚背和左脚背的SWV值高于健康对照者（p < 0.05）。在dcSSc患者中，未受累皮肤的SWV值高于对照组（p < 0.001），除皮肤评分3外，SWV值随皮肤评分增加而升高（p < 0.05）。SWV值总和与临床皮肤总分相关（r = 0.841，p < 0.001），皮肤厚度总和与临床皮肤总分相关（r = 0.740，p = 0.002）。
ARFI定量技术对于评估dcSSc患者的皮肤受累情况是可行且可靠的。ARFI定量技术能够识别在可触及的皮肤受累之前可能出现的早期皮肤变化，可能是SSc患者皮肤评估中有价值的辅助手段。
