Friedrich Stefanie, Lüders Susanne, Werner Stephanie Gabriele, Glimm Anne-Marie, Burmester Gerd-Rüdiger, Riemekasten Gabriela, Backhaus Marina, Ohrndorf Sarah
Department of Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany.
Rheumatologie, Immunologie und Osteologie mit, Schwerpunkt für Rheumatologie, Klinische Immunologie und Osteologie am Ev. Krankenhaus Düsseldorf, Düsseldorf, Germany.
Arthritis Res Ther. 2017 May 8;19(1):87. doi: 10.1186/s13075-017-1300-6.
Utilising fluorescence optical imaging (FOI), the distribution of an intravenously applied colouring agent indocyanine green (ICG) can be analysed with the potential to identify malperfusion by little to no tissue enhancement. Systemic sclerosis (SSc) is characterised by the presence of digital ulcers reflecting progressive vasculopathy. The objective was to investigate the potential of FOI in the detection of disturbed microcirculation in the hands and fingers of patients with SSc and to link FOI findings to clinical signs of ischemia such as digital ulcers and pitting scars.
In this cross-sectional study, 63 patients with SSc and 26 healthy subjects were examined. FOI was performed in all 89 individuals and compared to clinical data and capillaroscopic findings assembled for the SSc cohort.
Healthy subjects showed initial ICG signals in their fingertips in 93.6%, SSc patients in 78.5% (limited SSc) and 43.2% (diffuse SSc). Moreover, in SSc patients, FOI findings were significantly associated with a late capillaroscopic pattern, disseminated SSc features, a diffuse SSc subtype, and the presence of digital ulcers or pitting scars. Intra- and inter-reader reliability for FOI amounted to κ = 0.786 and κ = 0.834, respectively.
FOI is able to detect areas of reduced microcirculation in patients with SSc with high association to capillaroscopic findings. The results pave the way for future FOI investigations into its role in the prediction of complications due to an impaired acral perfusion.
利用荧光光学成像（FOI），可以分析静脉注射的染色剂吲哚菁绿（ICG）的分布情况，其有潜力通过极少或无组织增强来识别灌注不良。系统性硬化症（SSc）的特征是存在反映进行性血管病变的指端溃疡。目的是研究FOI在检测SSc患者手部和手指微循环紊乱方面的潜力，并将FOI结果与缺血的临床体征（如指端溃疡和点状瘢痕）联系起来。
在这项横断面研究中，对63例SSc患者和26名健康受试者进行了检查。对所有89名个体进行了FOI检查，并与为SSc队列收集的临床数据和毛细血管镜检查结果进行了比较。
93.6%的健康受试者指尖出现初始ICG信号，局限性SSc患者中这一比例为78.5%，弥漫性SSc患者中为43.2%。此外，在SSc患者中，FOI结果与晚期毛细血管镜检查模式、弥漫性SSc特征、弥漫性SSc亚型以及指端溃疡或点状瘢痕的存在显著相关。FOI的阅片者内和阅片者间可靠性分别为κ = 0.786和κ = 0.834。
FOI能够检测出SSc患者微循环减少的区域，且与毛细血管镜检查结果高度相关。这些结果为未来关于FOI在预测因肢端灌注受损导致的并发症中作用的研究铺平了道路。
