Ultrasound assessment of skin thickness and stiffness: the correlation with histology and clinical score in systemic sclerosis

被引:47
作者
Chen, Chen [1 ,2 ]
Cheng, Yi [3 ]
Zhu, Xiaoxia [1 ,2 ]
Cai, Yehua [3 ]
Xue, Yu [1 ,2 ]
Kong, Ning [1 ,2 ]
Yu, Yiyun [1 ,2 ]
Xuan, Dandan [1 ,2 ]
Zheng, Shucong [1 ,2 ]
Yang, Xue [1 ,2 ]
Zhu, Zaihua [1 ,2 ]
Zhao, Tianyi [1 ,2 ]
Wan, Weiguo [1 ,2 ]
Zou, Hejian [1 ,2 ]
Liang, Minrui [1 ,2 ]
机构
[1] Fudan Univ, Huashan Hosp, Div Rheumatol, 12 Wulumuqi Zhong Rd, Shanghai 200040, Peoples R China
[2] Fudan Univ, Inst Rheumatol Immunol & Allergy, Shanghai, Peoples R China
[3] Fudan Univ, Huashan Hosp, Dept Ultrasound, Shanghai, Peoples R China
基金
中国国家自然科学基金;
关键词
Ultrasound; Shear wave elastography; Systemic sclerosis; Histology; CLASSIFICATION;
D O I
10.1186/s13075-020-02285-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Ultrasound is a useful tool to evaluate and quantify skin lesions. Few studies have assessed the criterion validity of skin ultrasound in systemic sclerosis (SSc). The aims of the study were to investigate skin thickness and stiffness using ultrasound and shear wave elastography (SWE) in SSc and to validate skin ultrasound measurements against histological skin thickness. Methods: A total of 22 patients with diffuse cutaneous SSc (dcSSc), 22 with limited cutaneous SSc (lcSSc), and 22 age- and gender-matched healthy controls were enrolled. Skin thickness and stiffness were measured by B-mode ultrasound with SWE imaging on the bilateral fingers and hands. Additional ultrasound evaluation was carried out in 13 patients (9 dcSSc and 4 lcSSc) on their dorsal forearms, followed by skin biopsy conducted in the same skin areas. Correlations between ultrasound measurements and histological skin thickness and modified Rodnan skin score (mRSS) were investigated using Spearman's correlation. Results: Compared with controls, ultrasound-measured skin thickness and skin stiffness were significantly higher in patients with SSc (p < 0.001) and even higher in those with dcSSc. No clear correlation could be established between ultrasound-determined skin thickness and stiffness at the same site. Ultrasound-measured skin thickness correlated well with histological skin thickness (r = 0.6926,p = 0.009). A weaker association was also observed between histological skin thickness and local mRSS (r = 0.5867,p = 0.050). Conclusions: Ultrasound is a reliable tool for quantifying skin involvement in SSc. Ultrasound-measured skin thickness showed good agreement with histological skin thickness.
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页数:8
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