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Systemic sclerosis is an autoimmune disease characterized by organ fibrosis and vasculopathy. Almost all patients suffer from Raynaud’s phenomenon. Nailfold video capillaroscopy is the most widely imaging technique available, but flow quantification is impossible. Therefore, novel imaging techniques are of interest. We performed a single-center feasibility study using Microvascular Imaging (MVI) for flow quantification of small fingertip vessels. We compared 20 healthy controls (HCs) with 20 systemic sclerosis (SSc) patients. In HCs, measurements were, on average, statistically significantly higher when combined for all fingers (median 10.68 vs. 6 cm/s, Δ = 4.68 cm/s, p &lt; 0.0001) and for individual fingers. An optimal cut-off value of peak systolic (PS) velocity of &lt;6.13 cm/s and end-diastolic (ED) velocity of &lt;2.13 cm/s discriminated HCs from SSc. Test characteristics for PS showed excellent sensitivity (0.90, 95% CI 0.70–0.98) and specificity (0.85, 95% CI 0.64–0.95; LR + 6.0). For ED velocity, sensitivity was 0.85 (95% CI 0.64–0.95) and specificity was 0.80 (95% CI 0.58–0.92, LR + 4.25). Here, we present the first study on the use of MVI to assess blood flow in the fingertips with high sensitivity and specificity in SSc. Future studies are needed to investigate correlations with the risk of organ complications, such as digital ulcers or pulmonary arterial hypertension.

Microvascular Imaging as a Novel Tool for the Assessment of Blood Flow Velocity in Patients with Systemic Sclerosis: A Single-Center Feasibility Study