title: A preliminary study of acoustic radiation force impulse quantification for the assessment of skin in diffuse cutaneous systemic sclerosis.
abstract: OBJECTIVE
  To investigate skin elasticity using acoustic radiation force impulse (ARFI) quantification in systemic sclerosis (SSc), and compare the modified Rodnan skin score (mRSS) with measured shear wave velocity (SWV) and thickness of the skin.
  
  
  METHODS
  Fifteen patients with diffuse cutaneous SSc (dcSSc) and 15 age-matched and sex-matched healthy controls were evaluated. The SWV and thickness of skin were measured at 17 sites corresponding to those assessed in the mRSS in each participant. The SWV measurements of skin were compared between patients with dcSSc and healthy controls. The correlations between the mRSS and the skin SWV and thickness were explored using Spearman's correlation.
  
  
  RESULTS
  The SWV values were higher in patients with dcSSc compared with healthy controls at right hand dorsum, right forearm, left hand dorsum, left forearm, right foot dorsum, and left foot dorsum (p < 0.05). In patients with dcSSc, the SWV values of uninvolved skin were higher than those of controls (p < 0.001), and the SWV values increased with increasing skin scores except for skin score 3 (p < 0.05). The sum of the SWV values correlated with total clinical skin score (r = 0.841, p < 0.001), and the sum of the skin thickness correlated with total clinical skin score (r = 0.740, p = 0.002).
  
  
  CONCLUSIONS
  ARFI quantification is feasible and reliable for assessing the skin involvement in dcSSc. ARFI quantification could identify early skin change that may precede palpable skin involvement, and may be a valuable adjunct to skin evaluation in patients with SSc.
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Yong
authors.initials: Y
authors.lastname: Hou
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Qing-Li
authors.initials: QL
authors.lastname: Zhu
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: He
authors.initials: H
authors.lastname: Liu
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. jiangyuxinxh@163.com.
authors.forename: Yu-Xin
authors.initials: YX
authors.lastname: Jiang
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Meng-Tao
authors.initials: MT
authors.lastname: Li
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Zeng
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, and the Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Y. Hou, MD, PhD; D. Xu, MD, PhD; M-T. Li, MD, PhD; X-F. Zeng, MD; F-C. Zhang, MD; Department of Rheumatology and Clinical Immunology; Q-L. Zhu, MD, PhD; H. Liu, MD, PhD; Y-X. Jiang, MD; L. Wang, MD, PhD; Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Feng-Chun
authors.initials: FC
authors.lastname: Zhang
mesh_terms: D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D045743:Scleroderma, Diffuse / Q000473:pathology* / Q000503:physiopathology; D012867:Skin / Q000473:pathology* / Q000503:physiopathology
keywords: ACOUSTIC RADIATION FORCE IMPULSE QUANTIFICATION; SKIN INVOLVEMENT; SYSTEMIC SCLEROSIS