Premium
Comparison of 2‐D shear wave elastography with clinical score in localized scleroderma: A new method to increase the diagnostic accuracy
Author(s) -
Wang Ying,
Shan Jieling,
Chen Huyan,
Wu Zhifeng
Publication year - 2019
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.14713
Subject(s) - medicine , elastography , receiver operating characteristic , nuclear medicine , stage (stratigraphy) , acoustic radiation force , radiology , ultrasound , paleontology , biology
There is no established diagnostic criteria or widely accepted severity classification of localized scleroderma ( LS ) by imaging. Acoustic radiation force impulse ( ARFI ) technology by normalized mean shear wave velocity ( SWV ) may be as a probing tool for diagnosing and staging LS accurately and objectively. Fifty‐six patients with LS of inflammatory ( n = 21), sclerotic ( n = 24) and atrophic ( n = 11) stage and 30 healthy controls were evaluated on the basis of pathological results. Dermal thickness, ARFI quality (elastography score) and quantity (mean SWV ) were measured by ultrasonography ( US ), diagnosis and stage performances of LS using the dermal thickness, elastography score and mean SWV compared with modified localized scleroderma skin severity index ( mLoSSI ) were evaluated. Significant differences in the dermal thickness, elastography score and mean SWV were found between the normal adult and LS patients; for diagnosing LS , the area under the receiver–operator curves ( AUROC ) of the dermal thickness, elastography score, mean SWV and mLoSSI were 0.93 ± 0.03, 0.95 ± 0.01, 0.93 ± 0.03 and 0.93 ± 0.02, respectively. Compared with the dermal thickness, the elastography score and mLoSSI , the AUROC and the specificities of mean SWV for differentiating sclerotic from inflammatory stage and atrophic from sclerotic LS increased significantly, especially by normalized mean SWV ( AUROC , 0.84 ± 0.06 and 0.83 ± 0.07; specificity, 85.71% and 91.67%). As non‐invasive methods, mean SWV and dermal thickness by US may provide reliable information to diagnose and stage LS compared with mLoSSI especially by normalized mean SWV .