Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre.
Centre for Imaging Sciences, Division of Informatics, Imaging & Data Sciences, The University of Manchester, Manchester, UK.
Rheumatology (Oxford). 2021 May 14;60(5):2054-2065. doi: 10.1093/rheumatology/keab006.
We review the exciting potential (and challenges) of quantitative nailfold capillaroscopy, focusing on its role in systemic sclerosis. Quantifying abnormality, including automated analysis of nailfold images, overcomes the subjectivity of qualitative/descriptive image interpretation. First we consider the rationale for quantitative analysis, including the potential for precise discrimination between normal and abnormal capillaries and for reliable measurement of disease progression and treatment response. We discuss nailfold image acquisition and interpretation, and describe how early work on semi-quantitative and quantitative analysis paved the way for semi-automated and automated analysis. Measurement of red blood cell velocity is described briefly. Finally we give a personal view on 'next steps'. From a clinical perspective, increased uptake of nailfold capillaroscopy by general rheumatologists could be achieved via low-cost hand-held devices with cloud-based automated analysis. From a research perspective, automated analysis could facilitate large-scale prospective studies using capillaroscopic parameters as possible biomarkers of systemic sclerosis-spectrum disorders.
我们回顾了定量甲襞毛细血管镜检查的令人兴奋的潜力（和挑战），重点关注其在系统性硬化症中的作用。通过定量分析来量化异常，包括对甲襞图像进行自动分析，克服了定性/描述性图像解释的主观性。首先，我们考虑了定量分析的基本原理，包括精确区分正常和异常毛细血管的潜力，以及可靠测量疾病进展和治疗反应的潜力。我们讨论了甲襞图像的获取和解释，并描述了早期半定量和定量分析工作如何为半自动和自动分析铺平了道路。简要描述了红细胞速度的测量。最后，我们对“下一步”提出了个人看法。从临床角度来看，通过具有基于云的自动分析功能的低成本手持式设备，普通风湿病学家可以更多地采用甲襞毛细血管镜检查。从研究角度来看，自动化分析可以促进使用毛细血管参数作为系统性硬化症谱疾病的潜在生物标志物的大规模前瞻性研究。
