Paola Maria Cannaò1, Valeriano Vinci2, Fabio Caviggioli3, Marco Klinger2, Davide Orlandi4, Francesco Sardanelli5, Giovanni Serafini6, Luca Maria Sconfienza5. 1. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20100 Milano, Italy. 2. Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Humanitas Clinical and Research Center, University of Milano, Via Manzoni 56, Rozzano, 20098 Milan, Italy. 3. Reconstructive and Aesthetic Plastic Surgery School, Plastic Surgery Unit, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20099 Milan, Italy. 4. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genoa, Italy. 5. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 1, 20097 San Donato Milanese, Italy ; Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 1, San Donato Milanese, 20097 Milan, Italy. 6. Dipartimento di Radiologia, Ospedale Santa Corona, ASL 2 Savonese-Via XXV Aprile 38, 17027 Pietra Ligure (SV), Italy.
Abstract
PURPOSE: To evaluate the technical feasibility of real-time elastography (RTE) to assess the stiffness of the skin of the peri-oral region in patients affected by systemic sclerosis (SSc). METHODS: Six female patients affected by SSc (median age = 52 years) presenting with microstomia and six healthy controls matched for age and sex underwent RTE evaluation of the peri-oral region. Two operators with different experience evaluated the stiffness of the peri-oral region placing the probe in four different positions: parasagittal left (PL), parasagittal right (PR), upper axial (UA), lower axial (LA). Color map was converted into a semi-quantitative scale in which blue = 1, green = 2 and red = 3. Thus, each subject had a variable score ranging from 4 (four positions × value = 1) and 12 (four positions × value = 3). Mann-Whitney U and k statistics were used. RESULTS: RTE demonstrated that the skin of the peri-oral region of patients affected by SSc was stiffer than that of controls, both overall (6;4-6 [median; 25-75th percentile] vs. 11;9-11, p < 0.001) and for each probe position (PL = 1;1-2 vs. 2;2-3, PR = 1;1-2 vs. 2;2-3, UA = 1;1-2 vs. 2;2-3; LA = 1;1-1 vs. 3;3-3, p ≤ 0.011 for all). Interobserver reproducibility was excellent both overall and for each probe position (k = 1). CONCLUSION: RTE is a feasible modality to assess peri-oral region skin stiffness with excellent interobserver reproducibility. Further studies on a larger cohort of patients including more clinical data and measures are warranted to confirm our initial results.
PURPOSE: To evaluate the technical feasibility of real-time elastography (RTE) to assess the stiffness of the skin of the peri-oral region in patients affected by systemic sclerosis (SSc). METHODS: Six female patients affected by SSc (median age = 52 years) presenting with microstomia and six healthy controls matched for age and sex underwent RTE evaluation of the peri-oral region. Two operators with different experience evaluated the stiffness of the peri-oral region placing the probe in four different positions: parasagittal left (PL), parasagittal right (PR), upper axial (UA), lower axial (LA). Color map was converted into a semi-quantitative scale in which blue = 1, green = 2 and red = 3. Thus, each subject had a variable score ranging from 4 (four positions × value = 1) and 12 (four positions × value = 3). Mann-Whitney U and k statistics were used. RESULTS: RTE demonstrated that the skin of the peri-oral region of patients affected by SSc was stiffer than that of controls, both overall (6;4-6 [median; 25-75th percentile] vs. 11;9-11, p < 0.001) and for each probe position (PL = 1;1-2 vs. 2;2-3, PR = 1;1-2 vs. 2;2-3, UA = 1;1-2 vs. 2;2-3; LA = 1;1-1 vs. 3;3-3, p ≤ 0.011 for all). Interobserver reproducibility was excellent both overall and for each probe position (k = 1). CONCLUSION: RTE is a feasible modality to assess peri-oral region skin stiffness with excellent interobserver reproducibility. Further studies on a larger cohort of patients including more clinical data and measures are warranted to confirm our initial results.
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