Miziołek Bartosz, Lis-Święty Anna, Skrzypek-Salamon Alina, Brzezińska-Wcisło Ligia
Department of Dermatology, School of Medicine, Medical University of Silesia, Katowice, Poland.
Postepy Dermatol Alergol. 2021 Feb;38(2):115-122. doi: 10.5114/ada.2021.104286. Epub 2021 Mar 10.
Systemic sclerosis (SSc) is a multisystemic disease with an extensive microvasculopathy. The gold standard for its investigation is nailfold videocapillaroscopy (NVC).
To assess the value of thermography (IRT) for the assessment of microvasculopathy in patients with SSc.
Nineteen patients with limited cutaneous SSc were enrolled in the study. They underwent IRT imaging and NVC. An average temperature (Tavg) at the nailfold and a gradient of temperatures (ΔTavg) between the central metacarpus of the hand and the nailfold was determined for all fingers. NVC pictures were classified to capillaroscopic patterns according to Cutolo . system and they were analysed quantitatively to measure the density of capillaries and to calculate capillaroscopic skin ulcers risk index (CSURI) for each finger separately.
There was only a moderate correlation (0.4 < < 0.6) between thermographic parameters and density of capillaries in fingers II-V ( = 0.5; < 0.001 for Tavg and = -0.45; < 0.001 for ΔTavg), but none in thumbs ( = 0.29; = 0.089 for Tavg and = -0.19; = 0.275 for ΔTavg). Early pattern was associated with a significantly greater surface temperature (Tavg) of nailfolds and essentially milder ΔTavg in fingers II-V when compared to all other capillaroscopic patterns in fingers II-V. Surface temperature (Tavg) was significantly lower and ΔTavg was markedly more pronounced in fingers II-V with a greater risk of development of digital ulcers (DU) calculated by CSURI.
Although IRT measurements correlate only moderately with density of capillaries, this technique seems to be substantial to determine the capillaroscopic pattern and to identify patients at greater risk of DU development.
系统性硬化症（SSc）是一种伴有广泛微血管病变的多系统疾病。其检查的金标准是甲襞视频毛细血管显微镜检查（NVC）。
评估热成像（IRT）在评估系统性硬化症患者微血管病变中的价值。
19例局限性皮肤型系统性硬化症患者纳入本研究。他们接受了IRT成像和NVC检查。测定所有手指甲襞的平均温度（Tavg）以及手部中央掌骨与甲襞之间的温度梯度（ΔTavg）。根据库托洛系统将NVC图片分类为毛细血管显微镜检查模式，并对其进行定量分析，以分别测量每个手指的毛细血管密度并计算毛细血管显微镜检查皮肤溃疡风险指数（CSURI）。
热成像参数与II - V指的毛细血管密度之间仅存在中等程度的相关性（0.4＜r＜0.6）（Tavg的r = 0.5；P＜0.001，ΔTavg的r = -0.45；P＜0.001），但拇指不存在相关性（Tavg的r = 0.29；P = 0.089，ΔTavg的r = -0.19；P = 0.275）。与II - V指的所有其他毛细血管显微镜检查模式相比，早期模式与甲襞的表面温度（Tavg）显著更高以及II - V指的ΔTavg基本更温和相关。通过CSURI计算得出，II - V指发生指端溃疡（DU）风险更高的患者，其表面温度（Tavg）显著更低，ΔTavg明显更显著。
尽管IRT测量与毛细血管密度仅存在中等程度的相关性，但该技术似乎对于确定毛细血管显微镜检查模式以及识别发生DU风险更高的患者很重要。
