Tinazzi Ilaria, Idolazzi Luca, Zabotti Alen, Arancio Luisa, Batticiotto Alberto, Caimmi Cristian, De Lucia Orazio, Fassio Angelo, Girolimetto Nicolò, Macchioni Pierluigi, Murgo Antonella, Sakellariou Garifallia, Iagnocco Annamaria
Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy.
Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Verona, Italy.
Med Ultrason. 2019 Nov 24;21(4):414-421. doi: 10.11152/mu-2258.
To define and score finger soft tissue oedema in psoriatic dactylitis by ultrasound.
A systematic literature review (SLR) on ultrasound-detected finger soft tissue oedema was performed. Subsequently, based on the SLR, a Delphi survey was developed and circulated among a group of 13 expert sonographers, in order to obtain agreement on detection, definition and scoring of finger oedema by B-mode and power Doppler ultrasound. Agreement was considered achieved when each statement was approved by >75% of participants.
At the first Delphi round, 91 % agreement was obtained for the scanning technique to adopt, including the most appropriate area to evaluate. At the second round, 76% agreement was achieved on the definition of soft tissue finger oedema. At the third round, 76% agreement was obtained for B-mode and power Doppler scores. The volar aspect of the finger and comparisons with the contralateral side were agreed to be the most appropriate in terms of scanning technique. Agreed ultrasound definition of finger soft tissue oedema was "abnormal hypoechoic/anechoic areas, diffused or localized within the subcutaneous tissue between the epidermidis and the tendon-related anatomic structures (i.e. flexor tendon sheath, peritenonium, tendon pulleys), with local thickening, with or without local abnormal Doppler signal, visualised in two perpendicular planes and not evident on the contralateral side". Semiquantitative (0-3) scores for both B-mode and power Doppler were agreed to be the most appropriate to be used.
Our work produced, for the first time, technical indications, definition and scoring for the ultrasound assessment of soft tissue oedema in psoriatic dactylitis.
通过超声界定并评估银屑病性指（趾）炎患者手指软组织水肿情况并进行评分。
针对超声检测手指软组织水肿进行系统文献综述。随后，基于该综述设计了德尔菲调查问卷，并在13名超声专家小组中进行发放，以就B超和能量多普勒超声检测、界定及评估手指水肿达成共识。当每项陈述获得超过75%参与者认可时，视为达成共识。
在第一轮德尔菲调查中，对于采用的扫描技术，包括最适合评估的区域，达成了91%的共识。在第二轮调查中，关于手指软组织水肿的定义达成了76%的共识。在第三轮调查中，B超和能量多普勒评分达成了76%的共识。就扫描技术而言，手指掌侧以及与对侧进行比较被认为是最合适的。手指软组织水肿的超声定义达成共识为“异常低回声/无回声区，在表皮与肌腱相关解剖结构（即屈肌腱鞘、腱周组织、肌腱滑车）之间的皮下组织内呈弥漫性或局限性，伴有局部增厚，有或无局部异常多普勒信号，在两个垂直平面上可见且对侧不明显”。B超和能量多普勒的半定量（0 - 3）评分被一致认为是最适合使用的。
我们的研究首次得出了银屑病性指（趾）炎软组织水肿超声评估的技术指征、定义及评分。
