系统性硬皮病多器官受累超声评估研究进展
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摘要
系统性硬皮病是多器官受累的系统性疾病,采用影像方法评估其结构受损程度对于早期诊断、及时治疗及定期随访十分必要。综述常规超声及弹性超声在系统性硬皮病(如皮肤厚度与硬度、骨肌病变、肺间质纤维化及微血管病变)评估中的潜在应用价值及其超声表现,归纳总结了超声对系统性硬皮病多器官受累的不同评估价值的最新进展。
Systemic sclerosis is a kind of systemic disease with multiple organ involvement. It is essential to evaluate the structure damage with imaging tools for early diagnosis, timely treatment, and regular follow-up. This paper reviewed the potential application and ultrasonic manifestations of conventional ultrasound and ultrasound elastography in systemic sclerosis, such as assessment of skin thickness and stiffness, musculoskeletal lesions, pulmonary interstitial fibrosis and the microvascular lesions, and summarized the recent development of ultrasound for evaluation of multiple organ involvement in systemic sclerosis.
Systemic sclerosis is a kind of systemic disease with multiple organ involvement. It is essential to evaluate the structure damage with imaging tools for early diagnosis, timely treatment, and regular follow-up. This paper reviewed the potential application and ultrasonic manifestations of conventional ultrasound and ultrasound elastography in systemic sclerosis, such as assessment of skin thickness and stiffness, musculoskeletal lesions, pulmonary interstitial fibrosis and the microvascular lesions, and summarized the recent development of ultrasound for evaluation of multiple organ involvement in systemic sclerosis.
引文
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[2]Hesselstrand R,Scheja A,Wildt M,et al.High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema,extension and severity in early disease[J].Rheumatology,2008,47:84-87.
[3]Clements P,Lachenbruch P,Siebold J,et al.Inter and intra observer variability of total skin thickness score(modified Rodnan TSS)in systemic sclerosis[J].J Rheumatol,1995,22:1281-1285.
[4]Czirjak L,Foeldvari I,Muller-Ladner U.Skin involvement in systemic sclerosis[J].Rheumatology(Oxford),2008,47:v44-v45.
[5]Kaloudi O,Bandinelli F,Filippucci E,et al.High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis[J].Ann Rheum Dis,2010,69:1140-1143.
[6]Sedky MM,Fawzy SM,El Baki NA,et al.Systemic sclerosis:an ultrasonographic study of skin and subcutaneous tissue in relation to clinical findings[J].Skin Res Technol,2013,19:e78-e84.
[7]Hashikabe M,Ohtsuka T,Yamazaki S.Quantitative echographic analysis of photochemotherapy on systemic sclerosis skin[J].Arch Dermatol Res,2005,296:522-527.
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[9]Brocks K,Stender I,Karlsmark T,et al.Ultrasonic measurement of skin thickness in patients with systemic sclerosis[J].Acta Derm Venereol,2000,80:59-60.
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[12]Iagnocco A,Kaloudi O,Perella C,et al.Ultrasound elastography assessment of skin involvement in systemic sclerosis:lights and shadows[J].J Rheumatol,2010,37:1688-1691.
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[14]CannaòPM,Vinci V,Caviggioli F,et al.Technical feasibility of real-time elastography to assess the peri-oral region in patients affected by systemic sclerosis[J].J Ultrasound,2014,17:265-269.
[15]Cosgrove OD,Berg WA,Dore CJ,et al.Shear wave elastography for breast masses is highly reproducible[J].Eur Radiol,2012,22:1023-1032.
[16]Hou Y,Zhu QL,Liu H,et al.A preliminary study of acoustic radiation force impulse quantification for the assessment of skin in diffuse cutaneous systemic sclerosis[J].J Rheumatol,2015,42:449-455.
[17]Lee SY,Cardones AR,Doherty J,et al.Preliminary results of the feasibility of using AFRI/SWEI to assess cutaneous sclerotic diseases[J].Ultrasound Med Biol,2015,41:2806-2819.
[18]Santiago T,Alcacer-Pitarch B,Salvador MJ,et al.A preliminary study using virtual touch imaging and quantification for the assessment of skin stiffness in systemic sclerosis[J].Clin Exp Rheumatol,2016,34 Suppl 100:137-141.
[19]Liu H,Hou Y,Zhu Q L,et al.A preliminary study of skin ultrasound in diffuse cutaneous systemic sclerosis:does skin echogenicity matter[J].PLo S One,2017,12:e0174481.
[20]Avouac J,Walker U,Tyndall A,et al.Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis:results from the EULAR Scleroderma Trial and Research Group(EUSTAR)database[J].J Rheumatol,2010,37:1488-1501.
[21]Avouac J,Mogavero G,Guerini H,et al.Predictive factors of hand radiographic lesions in systemic sclerosis:a prospective study[J].Ann Rheum Dis,2011,70:630-633.
[22]Randone SB,Guiducci S,Cerinic MM.Musculoskeletal involvement in systemic sclerosis[J].Best Pract Res Clin Rheumatol,2008,22:339-350.
[23]Cuomo G,Zappia M,Abignano G,et al.Ultrasonographic features of the hand and wrist in systemic sclerosis[J].Rheumatology,2009,48:1414-1417.
[24]Chitale S,Ciapetti A,Hodgson R,et al.Magnetic resonance imaging and musculoskeletal ultrasonography detect and characterize covert inflammatory arthropathy in systemic sclerosis patients with arthralgia[J].Rheumatology(Oxford),2010,49:2357-2361.
[25]Abdel-Magied RA,Lotfi A,Abdel Gawad EA.Magnetic resonance imaging versus musculoskeletal ultrasonography in detecting inflammatory arthropathy in systemic sclerosis patients with hand arthralgia[J].Rheumatol Int,2013,33:1961-1966.
[26]Freire V,Bazeli R,Elhai M,et al.Hand and wrist involvement in systemic sclerosis:US features[J].Radiology,2013,269:824-830.
[27]Elhai M,Guerini H,Bazeli R,et al.Ultrasonographic hand features in systemic sclerosis and correlates with clinical,biologic,and radiographic findings[J].Arthritis Care Res,2012,64:1244-1249.
[28]Iagnocco A,Vavala C,Vasile M,et al.Power doppler ultrasound of the hand and wrist joints in systemic sclerosis[J].Clin Exp Rheumatol,2013,31(2 Suppl 76):89-95.
[29]Cuomo G,Zappia M,Iudici M,et al.The origin of tendon friction rubs in patients with systemic sclerosis:a sonographic explanation[J].Arthritis Rheum,2012,64:1291-1293.
[30]Tagliafico A,Panico N,Serafini G,et al.The thickness of the A1pulleys reflects the disability of hand mobility in scleroderma.A pilot study using highfrequency ultrasound[J].Eur J Radiol,2011,77:254-257.
[31]Kilic E,Kilic G,Akgul O,et al.Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis[J].Mod Rheumatol,2015,25:731-736.
[32]Assayag D,Kaduri S,Hudson M.High resolution computed tomography scoring system for evaluating interstitial lung disease in systemic sclerosis patients[J].Rheumatol Curr Res,2012,2012:S1-S3.
[33]Mohammadi A,Oshnoei S,Ghasemi-rad M.Comparison of a new,modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma[J].Med Ultrason,2014,16:27-31.
[34]Tardella M,Gutierrez M,Salaffi F,et al.Ultrasound in the assessment of pulmonary fibrosis in connective tissue disorders:correlation with high-resolution computed tomography[J].J Rheumatol,2012,39:1641-1647.
[35]Gutierrez M,Salaffi F,Carotti M,et al.Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders—preliminary results[J].Arthritis Res Ther,2011,13:R134.
[36]Gargani L,Doveri M,D’Errico L,et al.Ultrasound lung comets in systemic sclerosis:a chest sonography hallmark of pulmonary interstitial fibrosis[J].Rheumatology,2009,48:1382-1387.
[37]Pinal-Fernandez I,Pallisa-Nunez E,Selva-O’Callaghan A,et al.Pleural irregularity,a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome[J].Clin Exp Rheumatol,2015,33:S136-S141.
[38]Block JA,Sequeira W.Raynaud’s phenomenon[J].Lancet,2001,357:2042-2048.
[39]Wigley FM.Raynaud’s phenomenon[J].N Engl J Med.2002,347:1001-1008.
[40]Keberle M,Tony HP,Jahns R,et al.Assessment of microvascular changes in Raynaud’s phenomenon and connective tissue disease using colour doppler ultrasound[J].Rheumatology,2000,39:1206-1213.
[41]Lee SI,Lee SY,Yoo WH.The usefulness of power doppler ultrasonography in differentiating primary and secondary Raynaud’s phenomenon[J].Clin Rheumatol,2006,25:814-818.
[42]Schmidt WA,Krause A,Schicke B,et al.Color doppler ultrasonography of hand and finger arteries to differentiate primary from secondary forms of Raynaud’s phenomenon[J].J Rheumatol,2008,35:1591-1598.
[2]Hesselstrand R,Scheja A,Wildt M,et al.High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema,extension and severity in early disease[J].Rheumatology,2008,47:84-87.
[3]Clements P,Lachenbruch P,Siebold J,et al.Inter and intra observer variability of total skin thickness score(modified Rodnan TSS)in systemic sclerosis[J].J Rheumatol,1995,22:1281-1285.
[4]Czirjak L,Foeldvari I,Muller-Ladner U.Skin involvement in systemic sclerosis[J].Rheumatology(Oxford),2008,47:v44-v45.
[5]Kaloudi O,Bandinelli F,Filippucci E,et al.High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis[J].Ann Rheum Dis,2010,69:1140-1143.
[6]Sedky MM,Fawzy SM,El Baki NA,et al.Systemic sclerosis:an ultrasonographic study of skin and subcutaneous tissue in relation to clinical findings[J].Skin Res Technol,2013,19:e78-e84.
[7]Hashikabe M,Ohtsuka T,Yamazaki S.Quantitative echographic analysis of photochemotherapy on systemic sclerosis skin[J].Arch Dermatol Res,2005,296:522-527.
[8]Akesson A,Hesselstrand R,Scheja A,et al.Longitudinal development of skin involvement and reliability of high frequency ultrasound in systemic sclerosis[J].Ann Rheum Dis,2005,6:791-796.
[9]Brocks K,Stender I,Karlsmark T,et al.Ultrasonic measurement of skin thickness in patients with systemic sclerosis[J].Acta Derm Venereol,2000,80:59-60.
[10]Moore TL,Lunt M,Mc Manus B,et al.Seventeen-point dermal ultrasound scoring system-a reliable measure of skin thickness in patients with systemic sclerosis[J].Rheumatology(Oxford),2003,42:1559-1563.
[11]Sulli A,Ruaro B,Smith V,et al.Subclinical dermal involvement is detectable by high frequency ultrasound even in patients with limited cutaneous systemic sclerosis[J].Arthritis Res Ther,2017,19:61.
[12]Iagnocco A,Kaloudi O,Perella C,et al.Ultrasound elastography assessment of skin involvement in systemic sclerosis:lights and shadows[J].J Rheumatol,2010,37:1688-1691.
[13]Di Geso L,Filippucci E,Girolimetti R,et al.Reliability of ultrasound measurements of dermal thickness at digits in systemic sclerosis:role of elastosonography[J].Clin Exp Rheumatol,2011,29:926-932.
[14]CannaòPM,Vinci V,Caviggioli F,et al.Technical feasibility of real-time elastography to assess the peri-oral region in patients affected by systemic sclerosis[J].J Ultrasound,2014,17:265-269.
[15]Cosgrove OD,Berg WA,Dore CJ,et al.Shear wave elastography for breast masses is highly reproducible[J].Eur Radiol,2012,22:1023-1032.
[16]Hou Y,Zhu QL,Liu H,et al.A preliminary study of acoustic radiation force impulse quantification for the assessment of skin in diffuse cutaneous systemic sclerosis[J].J Rheumatol,2015,42:449-455.
[17]Lee SY,Cardones AR,Doherty J,et al.Preliminary results of the feasibility of using AFRI/SWEI to assess cutaneous sclerotic diseases[J].Ultrasound Med Biol,2015,41:2806-2819.
[18]Santiago T,Alcacer-Pitarch B,Salvador MJ,et al.A preliminary study using virtual touch imaging and quantification for the assessment of skin stiffness in systemic sclerosis[J].Clin Exp Rheumatol,2016,34 Suppl 100:137-141.
[19]Liu H,Hou Y,Zhu Q L,et al.A preliminary study of skin ultrasound in diffuse cutaneous systemic sclerosis:does skin echogenicity matter[J].PLo S One,2017,12:e0174481.
[20]Avouac J,Walker U,Tyndall A,et al.Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis:results from the EULAR Scleroderma Trial and Research Group(EUSTAR)database[J].J Rheumatol,2010,37:1488-1501.
[21]Avouac J,Mogavero G,Guerini H,et al.Predictive factors of hand radiographic lesions in systemic sclerosis:a prospective study[J].Ann Rheum Dis,2011,70:630-633.
[22]Randone SB,Guiducci S,Cerinic MM.Musculoskeletal involvement in systemic sclerosis[J].Best Pract Res Clin Rheumatol,2008,22:339-350.
[23]Cuomo G,Zappia M,Abignano G,et al.Ultrasonographic features of the hand and wrist in systemic sclerosis[J].Rheumatology,2009,48:1414-1417.
[24]Chitale S,Ciapetti A,Hodgson R,et al.Magnetic resonance imaging and musculoskeletal ultrasonography detect and characterize covert inflammatory arthropathy in systemic sclerosis patients with arthralgia[J].Rheumatology(Oxford),2010,49:2357-2361.
[25]Abdel-Magied RA,Lotfi A,Abdel Gawad EA.Magnetic resonance imaging versus musculoskeletal ultrasonography in detecting inflammatory arthropathy in systemic sclerosis patients with hand arthralgia[J].Rheumatol Int,2013,33:1961-1966.
[26]Freire V,Bazeli R,Elhai M,et al.Hand and wrist involvement in systemic sclerosis:US features[J].Radiology,2013,269:824-830.
[27]Elhai M,Guerini H,Bazeli R,et al.Ultrasonographic hand features in systemic sclerosis and correlates with clinical,biologic,and radiographic findings[J].Arthritis Care Res,2012,64:1244-1249.
[28]Iagnocco A,Vavala C,Vasile M,et al.Power doppler ultrasound of the hand and wrist joints in systemic sclerosis[J].Clin Exp Rheumatol,2013,31(2 Suppl 76):89-95.
[29]Cuomo G,Zappia M,Iudici M,et al.The origin of tendon friction rubs in patients with systemic sclerosis:a sonographic explanation[J].Arthritis Rheum,2012,64:1291-1293.
[30]Tagliafico A,Panico N,Serafini G,et al.The thickness of the A1pulleys reflects the disability of hand mobility in scleroderma.A pilot study using highfrequency ultrasound[J].Eur J Radiol,2011,77:254-257.
[31]Kilic E,Kilic G,Akgul O,et al.Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis[J].Mod Rheumatol,2015,25:731-736.
[32]Assayag D,Kaduri S,Hudson M.High resolution computed tomography scoring system for evaluating interstitial lung disease in systemic sclerosis patients[J].Rheumatol Curr Res,2012,2012:S1-S3.
[33]Mohammadi A,Oshnoei S,Ghasemi-rad M.Comparison of a new,modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma[J].Med Ultrason,2014,16:27-31.
[34]Tardella M,Gutierrez M,Salaffi F,et al.Ultrasound in the assessment of pulmonary fibrosis in connective tissue disorders:correlation with high-resolution computed tomography[J].J Rheumatol,2012,39:1641-1647.
[35]Gutierrez M,Salaffi F,Carotti M,et al.Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders—preliminary results[J].Arthritis Res Ther,2011,13:R134.
[36]Gargani L,Doveri M,D’Errico L,et al.Ultrasound lung comets in systemic sclerosis:a chest sonography hallmark of pulmonary interstitial fibrosis[J].Rheumatology,2009,48:1382-1387.
[37]Pinal-Fernandez I,Pallisa-Nunez E,Selva-O’Callaghan A,et al.Pleural irregularity,a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome[J].Clin Exp Rheumatol,2015,33:S136-S141.
[38]Block JA,Sequeira W.Raynaud’s phenomenon[J].Lancet,2001,357:2042-2048.
[39]Wigley FM.Raynaud’s phenomenon[J].N Engl J Med.2002,347:1001-1008.
[40]Keberle M,Tony HP,Jahns R,et al.Assessment of microvascular changes in Raynaud’s phenomenon and connective tissue disease using colour doppler ultrasound[J].Rheumatology,2000,39:1206-1213.
[41]Lee SI,Lee SY,Yoo WH.The usefulness of power doppler ultrasonography in differentiating primary and secondary Raynaud’s phenomenon[J].Clin Rheumatol,2006,25:814-818.
[42]Schmidt WA,Krause A,Schicke B,et al.Color doppler ultrasonography of hand and finger arteries to differentiate primary from secondary forms of Raynaud’s phenomenon[J].J Rheumatol,2008,35:1591-1598.