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Ultrasound Classification of Finger Pulp Blood Flow in Patients With Systemic Sclerosis: A Pilot Study
Author(s) -
Lescoat Alain,
Robin François,
Belhomme Nicolas,
Ballerie Alice,
Saint Riquier Marine,
Sebillot Martine,
Albert JeanDavid,
Le Gallou Thomas,
Perdriger Aleth,
Jégo Patrick,
Coiffier Guillaume,
Cazalets Claire
Publication year - 2023
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24779
Subject(s) - medicine , confidence interval , ultrasound , intraclass correlation , blood flow , ultrasonography , odds ratio , cardiology , nuclear medicine , surgery , radiology , clinical psychology , psychometrics
Objective To define a semiquantitative classification of finger pulp blood flow (FPBF) and to evaluate whether this classification could be used to assess FPBF in healthy controls and in systemic sclerosis (SSc) patients. Methods Thirty controls and 86 SSc patients were consecutively included. A classification of FPBF including 5 grades (from grade 0 [no signal] to 4 [signal detected on the entire finger pulp, including the subepidermal vascular network]) was evaluated. This classification was explored in basal conditions and after hand baths in hot and cold water in controls. Its relevance was also assessed at room temperature in SSc patients. Results In controls, power Doppler ultrasonography (PDUS) of FPBF was improved after hot challenge ( P = 0.024), whereas cold challenge decreased FPBF ( P = 0.001). FPBF correlated with the vasodilation status assessed by the resistivity index of radial arteries (Spearman's correlation coefficient = –0.50, P = 0.0049). Grade 0 was more frequent in SSc patients than in controls (22.1% versus 3.3%; P < 0.05). In SSc patients, grade 0 was associated with severity markers of the digital vasculopathy such as digital ulcers (DUs) (current or past) ( P < 0.05) or ulnar artery occlusion ( P < 0.05). On the other hand, DUs were less frequent in patients with grade 4 ( P < 0.05). A pathologic threshold of <2 (grade 0 or 1) was significantly associated with DUs (odds ratio 6.67 [95% confidence interval 2.31–19.21], P < 0.0001). Conclusion PDUS allowed a semiquantitative evaluation of FBPF in SSc patients and controls. Further studies are warranted to validate these results in independent SSc populations and to compare PDUS to existing tools assessing digital blood flow.