Evaluation of Digital and Nailfold Perfusion in Systemic Sclerosis: Role of Ultrahigh-resolution Ultrasonography

Presentation Format: Oral presentation.

Purpose or Learning Objective: To investigate the role of spectral analysis performed with ultrahigh-resolution ultrasonography (US) in the evaluation of the peripheral vascular bed in patients with systemic sclerosis (SSc).

Methods or Background: US examinations were performed in both hands of 33 patients with SSc and 34 healthy controls. We performed Doppler spectral analysis of the second interdigital artery on both hands. The proximal resistive index (pRI) and the peak systolic velocity (PV) were calculated, orienting a 18–5 MHz transducer along the long axis of the vessel on the palmar aspect of the third interdigital space. Distal resistive index (dRI) was calculated performing Doppler spectral analysis at the level of a nailfold arteriole of the third finger using a 33–9 MHz probe. For this latter purpose we employed a proprietary technology based on Doppler technology and integrated within the US system (Superb Microvascular Imaging) that allows visualization and sampling of microvascular flows.

Results or Findings: Compared with controls, we found significant differences in patients’ PV and dRI, whereas we did not observe any change when we compared pRI. Patients showed lower PV: patients: PV mean = 8.38 (standard deviation [SD] = 3) cm/s; controls: PV mean = 11.14 (SD = 4.5) cm/s; p = 0.005, and higher dRI: patients: dRI mean = 0.65 (SD = 0.14); controls: dRI mean = 0.57 (SD = 0.11); p = 0.0115.

Conclusion: US spectral analysis is able to detect the disease-related variation in distal flow parameters in SSc patients. However, further studies with larger series are needed to validate the use of high-resolution US in the investigation of SSc peripheral vasculopathy.

Publication History

Article published online:
03 June 2021