目的:使用出色的微血管成像(SMI)研究青少年局限性硬皮病(JLS)病变的微血管变化,并评估SMI在评估疾病活动中的实用性。
方法:这项前瞻性研究纳入了2021年1月至2023年6月期间经病理诊断为JLS的16名儿童(7名男性)。使用局部硬皮病皮肤评估工具评估病变,包括局部硬皮病皮肤活动指数(LoSAI)和局部硬皮病皮肤损伤指数(LoSDI)。LoSAI评分>0的病变被分类为活动性。使用超声评估对侧部位的病变和健康皮肤层的厚度和血流量。SMI用于检测病变和健康皮肤中的微血管血流,计算血管指数(VI)。活动性病变和健康皮肤之间的VI差异与LoSAI和总分相关。
结果:在46个病变中,23个是活跃的,23个是不活跃的。皮损厚度0.094±0.024cm,健康部位为0.108±0.026cm(p<0.001)。活动皮损和健康皮肤的VI分别为7.60(3.60,12.80)%和1.10(0.50,2.10)%,分别(p<0.001)。非活动性病变和健康皮肤的VI分别为0.85(0.00,2.20)%和1.60(1.00,3.10)%,分别(p=0.011)。活动性病变和健康皮肤之间的VI差异与LoSAI临床评分(r=0.625,p=0.001)和总分(r=0.842,p<0.001)呈正相关。
结论:SMI可以定量检测JLS皮肤的微血管血流变化,指示病变活动和严重程度。
结论:SMI是一个方便的,非侵入性,用于检测活动性JLS病变的技术,可以提供有价值的信息来指导治疗方案。
结论:目前青少年局限性硬皮病的分级系统依赖于主观的临床信息。高超的微血管成像发现,活动性病变和健康皮肤之间的血管指数与临床评分呈正相关。精湛的微血管成像有效评估微血管血流,辅助青少年局部硬皮病病变活动评估。
OBJECTIVE: To investigate microvascular changes in juvenile localised
scleroderma (JLS) lesions using superb microvascular imaging (SMI) and assess SMI\'s utility in evaluating disease activity.
METHODS: This prospective
study enroled 16 children (7 males) with pathologically diagnosed JLS between January 2021 and June 2023. Lesions were assessed using Localised
Scleroderma Cutaneous Assessment Tools, including the localised
scleroderma skin activity index (LoSAI) and localised
scleroderma skin damage index (LoSDI). Lesions with LoSAI scores > 0 were classified as active. The thickness and blood flow of the lesions and healthy skin layers of the contralateral site were evaluated using ultrasound. SMI was used to detect microvascular blood flow in the lesions and healthy skin, and the vascular index (VI) was calculated. The difference in VI between active lesions and healthy skin was correlated with LoSAI and total scores.
RESULTS: Of 46 lesions, 23 were active and 23 inactive. The skin thickness of the lesion was 0.094 ± 0.024 cm, and that of the healthy site was 0.108 ± 0.026 cm (p < 0.001). The VI of the active lesions and healthy skin were 7.60 (3.60, 12.80)% and 1.10 (0.50, 2.10)%, respectively (p < 0.001). The VI of the inactive lesions and the healthy skin were 0.85 (0.00, 2.20)% and 1.60 (1.00, 3.10)%, respectively (p = 0.011). VI differences between active lesions and healthy skin positively correlated with the LoSAI clinical score (r = 0.625, p = 0.001) and total score (r = 0.842, p < 0.001).
CONCLUSIONS: SMI can quantitatively detect microvascular blood flow changes in JLS skin, indicating lesion activity and severity.
CONCLUSIONS: SMI is a convenient, non-invasive, technique for detecting active JLS lesions and can provide valuable information to guide treatment options.
CONCLUSIONS: Current grading systems of juvenile localised
scleroderma rely on subjective clinical information. Superb Microvascular Imaging identified that vascular indexes between active lesions and healthy skin positively correlated with clinical scores. Superb Microvascular Imaging effectively assesses microvascular blood flow, aiding juvenile localised scleroderma lesion activity evaluation.