Giavedoni Priscila, Podlipnik Sebastian, Fuertes de Vega Irene, Iranzo Pilar, Mascaró José Manuel
Department of Dermatology, Institut Clínic de Medicina i Dermatologia, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.
Medical School, University of Barcelona, 08036 Barcelona, Spain.
J Clin Med. 2021 Sep 29;10(19):4516. doi: 10.3390/jcm10194516.
Determining disease activity from clinical signs in patients with connective tissue panniculitis (CTP) is often challenging but is essential for therapeutic decision making, which largely relies on immunosuppressant treatment. High-frequency ultrasound (HFUS) may be useful in supporting such decisions by accurately determining CTP activity. This study aimed to investigate the accuracy of HFUS in identifying signs of CTP activity or inactivity and assess its usefulness in therapeutic decision making. A prospective cohort study of consecutive patients with biopsy-proven CTP receiving HFUS was conducted in a tertiary university hospital (2016-2020). HFUS was performed at inclusion and at each 3- or 6-month follow-up visit, depending on disease activity. Twenty-three patients with CTP were included, and 134 HFUSs were performed. In 59.7% (80) of the evaluations, the clinical presentation did not show whether CTP was active or not. In these cases, HFUS showed activity in 38.7% (31) and inactivity in 61.3% (49). In 71.25% (57) of the visits, HFUS was the determinant for therapeutic decisions. Further follow-up showed consistent clinical and HFUS responses in all unclear cases after treatment modification. HFUS appears to be a useful adjunct to the clinical examination for CTP to assess activity and make therapeutic decisions.
根据临床体征判断结缔组织性脂膜炎（CTP）患者的疾病活动度往往具有挑战性，但这对于治疗决策至关重要，因为治疗决策很大程度上依赖于免疫抑制剂治疗。高频超声（HFUS）可能有助于通过准确确定CTP活动度来支持此类决策。本研究旨在调查HFUS识别CTP活动或不活动体征的准确性，并评估其在治疗决策中的有用性。在一家三级大学医院（2016 - 2020年）对连续的经活检证实为CTP且接受HFUS检查的患者进行了一项前瞻性队列研究。根据疾病活动度，在纳入时以及每3个月或6个月的随访时进行HFUS检查。纳入了23例CTP患者，共进行了134次HFUS检查。在59.7%（80次）的评估中，临床表现未显示CTP是否处于活动状态。在这些病例中，HFUS显示活动的占38.7%（31次），不活动的占61.3%（49次）。在71.25%（57次）的就诊中，HFUS是治疗决策的决定因素。进一步随访显示，在所有治疗调整后仍不明确的病例中，临床和HFUS反应一致。对于CTP，HFUS似乎是临床检查的有用辅助手段，可用于评估活动度并做出治疗决策。
