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使用磁共振成像评估颅面部局限性硬皮病的损伤情况。

Damage evaluation of craniofacial localized scleroderma using magnetic resonance imaging.

作者信息

Ma Xuda, Huang Jiuzuo, Xue Huadan, Wang Hongwei, Wang Tianjiao, Chen Yu, Long Xiao, Wang Xiaojun

机构信息

Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Quant Imaging Med Surg. 2024 Feb 1;14(2):1891-1903. doi: 10.21037/qims-23-980. Epub 2024 Jan 19.

DOI:10.21037/qims-23-980
PMID:38415131
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10895148/
Abstract

BACKGROUND

Localized scleroderma (LoS) is an autoimmune disease in which craniofacial lesions can cause severe facial deformities with brain involvement. Objective evaluation of craniofacial LoS is challenging. Magnetic resonance imaging (MRI) may be used as a damage assessment tool. This study aimed to analyze the tissue involvement of craniofacial LoS based on MRI and evaluate MRI for craniofacial LoS assessment.

METHODS

This cross-sectional study included patients with craniofacial LoS from September 2021 to August 2022 in Peking Union Medical College Hospital. Patients who were clinically assessed in a stable phase were enrolled; patients with previous surgical treatment or contraindications to MRI were excluded. Participants underwent clinical, MRI, and ultrasound assessments. MRI was compared with ultrasound by correlation analysis and Bland-Altman analysis. The involvement of different tissues and different facial subunits was compared. The accumulated soft tissue atrophy index (ASTAI) was compared with clinical scores by correlation analysis.

RESULTS

A total of 28 patients were included (13 female; mean age, 18 years). MRI showed a good correlation and agreement with ultrasound (r=0.916, P<0.001). In different facial subunits, a significant negative correlation between the forehead and chin was found (r=-0.593, P=0.001). The ASTAI correlated well with the facial LoS damage index (r=0.580, P=0.001) and the Peking Union Medical College LoS facial aesthetic index (PUMC LoSFAI) (r=0.921, P<0.001). A total of 38.6% of clinical scores were inaccurate based on MRI. Neurological changes were found in one patient.

CONCLUSIONS

MRI can reliably quantify damage in craniofacial LoS, and may serve as a useful and objective tool for overall craniofacial LoS evaluation.

摘要

背景

局限性硬皮病（LoS）是一种自身免疫性疾病，其中颅面部病变可导致严重的面部畸形并累及脑部。对颅面部LoS进行客观评估具有挑战性。磁共振成像（MRI）可作为一种损伤评估工具。本研究旨在基于MRI分析颅面部LoS的组织受累情况，并评估MRI在颅面部LoS评估中的作用。

方法

本横断面研究纳入了2021年9月至2022年8月在北京协和医院就诊的颅面部LoS患者。纳入处于临床稳定期的患者；排除既往接受过手术治疗或有MRI检查禁忌证的患者。参与者接受了临床、MRI和超声评估。通过相关性分析和Bland-Altman分析比较MRI和超声结果。比较不同组织和不同面部亚单位的受累情况。通过相关性分析比较累积软组织萎缩指数（ASTAI）与临床评分。

结果

共纳入28例患者（13例女性；平均年龄18岁）。MRI与超声显示出良好的相关性和一致性（r=0.916，P<0.001）。在不同的面部亚单位中，前额和下巴之间存在显著的负相关（r=-0.593，P=0.001）。ASTAI与面部LoS损伤指数（r=0.580，P=0.001）和北京协和医院LoS面部美学指数（PUMC LoSFAI）（r=0.921，P<0.001）相关性良好。基于MRI，38.6%的临床评分不准确。在1例患者中发现了神经学改变。

结论

MRI能够可靠地量化颅面部LoS的损伤情况，可作为颅面部LoS整体评估的有用且客观的工具。

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