背景:局限性硬皮病,被称为morphea,是以皮肤和软组织的炎症和纤维化为特征的结缔组织病症。为了监测疾病活动,没有普遍接受的验证结果指标。除了评估结果指标的临床评分外,成像模式越来越多地用于评估患者,例如高频超声检查(美国),剪切波弹性成像(SWE),磁共振成像(MRI)。然而,目前尚不清楚这些成像方式在监测角膜活动方面的准确性。
目的:回顾有关影像学检查方法在评估硬伤患者中的作用的文献。
方法:在本研究中,我们在PubMed/Medline数据库中搜索了从开始到2023年2月发表的文章.
结果:美国三类共23篇原创文章,弹性成像,包括MRI。
结论:关于美国,标准,包括增加真皮厚度,增加了皮下组织的回声,真皮回声减少,当使用高频探头(18-20MHz)彩色多普勒超声检查时,是活动性角膜病变的指标。此外,评估SWE的研究,一种定量评估组织硬度的新方法,表现出活动性病变的真皮僵硬度增加。
结论:研究表明,MRI可以帮助确定疾病的深度,特别是作为一线和后续诊断工具,尤其是在广义和深层的角膜。此外,脑部MRI可能对出现新的或恶化的神经系统症状的局部颅面硬皮病患者有用.
BACKGROUND: Localized scleroderma, known as
morphea, is a connective tissue disorder characterized by inflammation and fibrosis of the skin and the soft tissue. There exist no universally accepted validated outcome measures in order to monitor the disease activity. Besides clinical scores to evaluate outcome measures, imaging modalities are increasingly utilized in assessing patients with
morphea, such as high-frequency ultrasonography (US), shear-wave elastography (SWE), and magnetic resonance imaging (MRI). However, the accuracy of these imaging modalities in monitoring
morphea activity is not yet clear.
OBJECTIVE: To
review the literature regarding the role of imaging modalities in assessing patients with
morphea.
METHODS: In this study, we searched the PubMed/Medline database for articles published from inception until February 2023.
RESULTS: A total number of 23 original articles in three categories of US, elastography, and MRI were included.
CONCLUSIONS: Regarding US, criteria, including increased dermal thickness, increased echogenicity of the subcutaneous tissue, and decreased dermal echogenicity, were indicators of active morphea lesions when using high frequencies probe (18-20 MHz) color Doppler sonography. Moreover, studies evaluating SWE, a novel method to quantitatively assess tissue stiffness, demonstrated increased dermal stiffness in active lesions.
CONCLUSIONS: Studies showed that MRI can help to determine the depth of disease, particularly as a first-line and follow-up diagnostic tool, especially in generalized and deep morphea. In addition, brain MRI may be useful for patients with localized craniofacial scleroderma experiencing new or worsening neurological symptoms.