UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
Department of Radiology, CHRU Tours, France.
Ultraschall Med. 2021 Oct;42(5):503-513. doi: 10.1055/a-1047-3146. Epub 2020 Mar 18.
High-frequency transient elastography (HF-TE) is a noninvasive technique for assessing shear-wave speed and finally elasticity in thin tissue such as the skin. It has never been validated for monitoring fibrotic skin diseases. The purpose was to evaluate the potential of HF-TE to assess skin fibrosis in patients with chronic venous disorders (CVD).
This clinical study enrolled 48 patients at various stages of CVD and 48 paired healthy volunteers. Subjects underwent a clinical examination with an evaluation of Rodnan's fibrosis skin score. We studied the dermis thickness measured using ultrasound (US) and elasticity measurements using cutometer and HF-TE studied according to 3 cutaneous zones positioned on the leg. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the diagnosis performance for a combined parameter (PRL) based on a logistic regression model using both elasticity and dermal thickness.
Patients with CVD had significantly higher values of skin elasticity than healthy subjects, 134.5 kPa and 132.1 kPa vs. 91.3 kPa, respectively. The dermis thickness also increased with escalation in CVD stage for all studied zones. The PRL parameter had an AUC value of 0.79 for all zones and stages of CVD clustered. The discriminating power of PRL increased with escalation of the CVD stage; with an AUC value of up to 0.89 for evolved stages, and a sensitivity and specificity of 0.79 and 0.89, respectively.
HF-TE, coupled with a US measurement of dermis thickness, made it possible to propose a new biomarker, which proved to be a good diagnostic tool for skin fibrosis.
高频瞬时弹性成像（HF-TE）是一种用于评估薄组织（如皮肤）剪切波速度和弹性的非侵入性技术。它从未在监测纤维化皮肤疾病方面得到验证。本研究旨在评估 HF-TE 评估慢性静脉疾病（CVD）患者皮肤纤维化的潜力。
本临床研究纳入了 48 名处于 CVD 不同阶段的患者和 48 名配对的健康志愿者。受试者接受了临床检查，并评估了罗德纳纤维化皮肤评分。我们使用超声（US）测量真皮厚度，并使用皮肤弹性测量计（cutometer）测量弹性，根据腿部的 3 个皮肤区域定位进行 HF-TE 研究。计算接受者操作特征曲线（ROC）下的面积（AUC），以评估基于弹性和真皮厚度的逻辑回归模型的联合参数（PRL）的诊断性能。
CVD 患者的皮肤弹性值明显高于健康受试者，分别为 134.5 kPa 和 132.1 kPa 与 91.3 kPa。真皮厚度也随着 CVD 各阶段的进展而增加。PRL 参数在所有研究区域和 CVD 聚类阶段的 AUC 值为 0.79。PRL 的区分能力随着 CVD 阶段的进展而增加；对于进展阶段，AUC 值高达 0.89，敏感性和特异性分别为 0.79 和 0.89。
HF-TE 结合 US 测量真皮厚度，提出了一种新的生物标志物，该标志物被证明是皮肤纤维化的一种良好诊断工具。
