The microvascular and morphostructural changes of nails in psoriatic patients with nail disease; a link between ultrasound and videocapillaroscopy findings in the nailfold

Objective: The objective of this study is to evaluate the link between nail fold vessel resistive index (NVRI) measured by ultrasound (US) and capillary loops diameters measured using nailfold videocapillarascopy (NVC), and to assess the morphological appearance of the nail bed in patients with psoriatic nail disease (PND) as compared with healthy controls (HCs).Material and methods: This study was conducted in patients with PND and HCs. General demographic data were collected and clinical assessments were performed for all subjects. The nail plate thickness (NPT) was measured on gray scale using US. The NVRI was measured using color Doppler (CD) US. The measurements of the apical, arterial, venous limb diameters and morpho-structural changes (tortuous, cross-linked capillaries) were assessed using NVC.Results: Thirty-four patients with PND and 15 HCs were enrolled in this study. The two groups were matched for age and body mass index (BMI). Patients with PND had higher NPT and NVRI in comparison with HCs [(20 (17-23) vs 14 (14-15), p<0.001), (0.55 (0.51-0.61) vs 0.43 (0.38-0.49), p<0.001), respectively]. A higher proportion of patients with PND had tortuous capillaries than HCs (62% and 20% respectively, p=0.005). The mean NVRI was higher in patients with PND who had tortuous capillaries than patients who did not have tortuous capillaries (0.58 (0.7) and 0.52 (0.09), respectively p=0.033).Conclusion: Microvascular changes can be detected easily using non-invasive methods such as US and NVC. These methods can provide an objective data to better assess PND.

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High-Frequency Ultrasonography and Evaporimetry in Non-invasive Evaluation of the Nail Unit

Frontiers in Medicine ◽

10.3389/fmed.2021.686470 ◽

2021 ◽

Vol 8 ◽

Author(s):

Marta Szymoniak-Lipska ◽

Adriana Polańska ◽

Dorota Jenerowicz ◽

Adam Lipski ◽

Ryszard Żaba ◽

...

Keyword(s):

High Frequency ◽

Complex Structure ◽

Plate Thickness ◽

Nail Plate ◽

Structure And Function ◽

Dominant Hand ◽

Entire Study ◽

Non Invasive ◽

High Frequency Ultrasonography ◽

And Function

Background: The nail unit (NU) is a complex structure that performs a number of functions, including protection, defense, manipulation, and palpation. Non-invasive research methods can facilitate the recognition of NU structure and function. Evaporimetry and HF-USG due to their availability of equipment and low research costs seem to be particularly noteworthy, but so far have been assessed to a limited extent. The aim of the presented study was to check the usefulness of TOWL and HF-USG in examination of NU.Materials and Methods: A total of 58 volunteers aged 25–65 years (mean age: 41 ± 10.16 years) were qualified for the study. The subjects did not present symptoms of clinically evident onychopathy and did not suffer from any dermatoses associated with lesions occurring within the NU. Additionally, the patients did not suffer from systemic diseases that could affect NU (including heart, lung, and endocrine diseases). In all volunteers, the measurement of TOWL and 20 MHz ultrasonography [high-frequency ultrasonography (HF-USG)] with the special emphasis on determination of nail plate thickness were performed.Results: Analysis of 464 HF-USG images revealed that the nail plate presented as two hyperechoic, parallel streaks (railway sign) with a linear hypoechoic middle layer between them. Matrix was visualized as a hypoechoic structure with blurred boundaries, mostly within the fourth and fifth fingers and more often in women. We found statistically significant correlations between the type of a finger and the thickness of the nail plate both in the entire study group and taking into account gender. In the dominant hand, the results were r = −0.341; p < 0.001; r = −0.417, p < 0.001; and r = 0.337; p = 0.001 (for the whole group, for women, and for men, respectively). In the non-dominant hand, the results were r = −0.465; p < 0.001; r = −0.493, p < 0.01; and r = −0.503; p < 0.01 (for the whole group, for women, and for men, respectively). There were statistically significant differences in the thickness of the nail plates of the corresponding types of fingers between female and male NUs. Statistically significant correlations were found between the type of a finger and the TOWL value in the whole group and taking into account gender (p < 0.05), except for the non-dominant hand in men. There were no statistically significant differences in the TOWL values of the corresponding types of fingers between male and female NUs (p > 0.05). There was no statistically significant correlation between the TOWL value and the nail plate thickness in any of the tested NUs, apart from the one statistically significant correlation in nd5 (r = 0.390, p = 0.021).Conclusions: To sum up, non-invasive methods, such as HF-USG and TOWL, enable assessment of the NU and are useful in examination of its structure and function. HF-USG shows characteristic elements of NUs that can be distinguished because of differences in their echogenicity. The thickness of the nail plate and TOWL depend on the type of finger, and show a relationship with gender.

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High-frequency sonography in the evaluation of nail psoriasis.

Medical Ultrasonography ◽

10.11152/mu.2013.2066.183.hgh ◽

2016 ◽

Vol 18 (3) ◽

pp. 312 ◽

Cited By ~ 8

Author(s):

Mihaela Elena Marina ◽

Carolina Botar Jid ◽

Sorana Daniela Bolboaca ◽

Corina Bocsa ◽

Carmen Mihaela Mihu ◽

...

Keyword(s):

Blood Flow ◽

High Frequency ◽

Color Doppler ◽

Plate Thickness ◽

Power Doppler ◽

Psoriasis Patient ◽

Nail Plate ◽

Resistance Index ◽

Doppler Imaging ◽

Nail Involvement

Aim: To evaluate the morphostructural aspects and nail vascularity in the nail unit of patients with psoriasis, and to evaluate whether there are differences among psoriatic patients with and without nail involvement. Material and methods: Nail plates and nail bed changes, nailfold vessel resistance index (NVRI), power and color Doppler blood flow appearances were investigated in 23 patients with moderate-to-severe psoriasis, with and without nail involvement, and compared to those of 11 healthy participants. Results: Ventral nail plate deposits were present only in psoriasis patients. Irregular or totally fused nail plates and increased nail plate thickness was frequently observed in psoriasis patients compared to controls. NVRI was increased in psoriatic patients’ nails compared to controls (0.62 vs. 0.57, p<0.0001). In the psoriasis patient group there was significant statistical difference in NVRI in patients with nail involvement compared to those without (0.66 vs. 0.55, p<0.0001). Conclusions: High-frequency gray scale sonography provides valuable information regarding morphostructural changes in nail unit structure in patients with psoriasis. Power Doppler imaging enables blood flow assessment in psoriasis nail induced changes.

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AB0796 PSORIATIC ONYCHOPATHY: MORE THAN MEETS THE EYE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3971 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1698.1-1698

Author(s):

I. Mahmoud ◽

S. Rahmouni ◽

A. Ben Tekaya ◽

S. Bouden ◽

R. Tekaya ◽

...

Keyword(s):

Plate Thickness ◽

Nail Plate ◽

Assessment Tools ◽

Moderate Activity ◽

Nail Matrix ◽

The Us ◽

Matrix Region ◽

The Mean ◽

Nail Disease ◽

Nail Involvement

Background:Psoriatic onychopathy is an independent predictor of the onset of psoriatic arthritis (PsA). Assessment of nail disease is difficult given the limited utility of clinical assessment tools for the nail.Recently, ultrasound (US) proved to be informative in the assessment of nail involvement.Objectives:We aimed to describe morphologic ultrasonographic nail disease changes and to look for correlations between these features and the characteristics of the PsA.Methods:The study included patients who met the CASPAR criteria for PsA.An US scan of patient’s nails was performed in order to study the nail, matrix and skin thickness.Results:We included 33 patients with PsA with a mean age of 51.2±12.5 years. The mean DAPSA was 22.8±19.7 (remission:9 patients, low activity: 5 patients, moderate activity: 11 patients and high activity: 8 patients).Twenty-nine patients had a personal history of skin psoriasis, present in 64 % of the patients the day of the examination with a mean PASI of 2.76 ±3.9.Eleven patients (33.4%) presented with psoriatic onychopathy (45 fingernails) with a mean mNAPSI of 14.1± 16.The most common patterns of nail involvement were:Oil-drop patches (5 fingernails), pitting (4 fingernails), onycholysis (3 fingernails), crumbling (3 fingernails), subungual hyperkeratosis (2 fingernails), leukonychia (2 fingernails),paronychia(2 fingernails), splinter hemorrhages (1 fingernail).We scanned 330 fingernails. The US study revealed dystrophy in 75 nails (22.7%) of the nails, in 17 patients (51.5%): Undulations or pitting (n=47), followed by disappearance of the anechoic space (n=38) and anechoic ventral nail plate (n=18).The mean thickness of skin, nail plate and nail matrix region were 2.25±0.32 mm, 0.38±0.07 mm and 1.89±0.33, respectively.We found a positive correlation between nail plate thickness and both skin and nail matrix region thickness (r=0.561, p=0.001 and r=0.523, p=0.002).Skin, nail and nail matrix thickness were significantly higher in men and in smokers. Manual workers did not have greater skin, nail plate nor nail matrix thickness.There were no correlations between disease activity evaluated by the ASDAS-CRP, DAS28, PASI, ESR or by CRP and any of the US parameters.In contrast, there was a significant negative correlation between psoriatic disease duration and nail plate thickness (r=-0.372, p=0,036).Conclusion:Ultrasound offers an appropriate alternative for the evaluation of the nail unit. In our study it was able to detect subclinical involvement of the nail in 30 fingernails and in two patients.Disclosure of Interests:None declared

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Mean resistive index as a prognostic tool for hydronephrosis in patients with acute renal colic: a study in a tertiary care

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170996 ◽

2017 ◽

Vol 4 (2) ◽

pp. 329 ◽

Cited By ~ 1

Author(s):

M. L. Ravindernath ◽

G. Mahender Reddy

Keyword(s):

Renal Colic ◽

Urinary Tract Obstruction ◽

Color Doppler ◽

Demographic Data ◽

Tertiary Care ◽

Resistive Index ◽

Flank Pain ◽

Specificity And Sensitivity ◽

Acute Renal Colic ◽

The Mean

Background: Uretolithiasis is one of the most common cause of urinary tract obstruction which leads to the admission into the emergency ward. The detection of urolithiasis or acute renal colic is by the radiography, conventional ultrasonography (US) and intravenous urography (IVU). A colour Doppler USG measures this change as a resistive index (RI) of the arcuate arteries at the corticomedullary junction or the interlobar arteries.Methods: 84 patients between the ages 15-50 years, who were admitted to the Emergency department of our hospital with unilateral renal colic were included into our study. Detailed demographic data was collected from all the patients and they were all subjected to a thorough physical and clinical examination. Bladder ultrasound was taken along with color Doppler for all the patients at the time of admission for every 6 hours. Thus, an increased RI index signifies an obstruction without a dilatation.Results: Left flank pain was slightly more than the right flank pain, although this was not found to be significant. Most of the patients were presented with vomiting or nausea and dysuria was seen in 48 patients. there were 41 cases of hydronephrosis in total and all of them were positive for mean RI. The specificity with the mean resistive index with color Doppler was 90%, while the sensitivity was 100%. Around 95% of the prediction was accurate with mean resistive index, with more than 90% efficiency.Conclusions: The mean resistive index is a very good tool for the diagnosis of hydronephrosis, with a very high level of specificity and sensitivity.

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Fine Structural Changes in the Microvasculature of the Mouse Pinna: Aging and Radiation Injury

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100050287 ◽

1974 ◽

Vol 32 ◽

pp. 54-55

Author(s):

S. Phyllis Steamer ◽

Rosemarie L. Devine

Keyword(s):

Structural Changes ◽

Radiation Treatment ◽

Arterial Stenosis ◽

Ultrastructural Changes ◽

Vascular Effects ◽

Microvascular Changes ◽

Surrounding Connective Tissue ◽

Fission Neutrons ◽

Total Body

The importance of radiation damage to the skin and its vasculature was recognized by the early radiologists. In more recent studies, vascular effects were shown to involve the endothelium as well as the surrounding connective tissue. Microvascular changes in the mouse pinna were studied in vivo and recorded photographically over a period of 12-18 months. Radiation treatment at 110 days of age was total body exposure to either 240 rad fission neutrons or 855 rad 60Co gamma rays. After in vivo observations in control and irradiated mice, animals were sacrificed for examination of changes in vascular fine structure. Vessels were selected from regions of specific interest that had been identified on photomicrographs. Prominent ultrastructural changes can be attributed to aging as well as to radiation treatment. Of principal concern were determinations of ultrastructural changes associated with venous dilatations, segmental arterial stenosis and tortuosities of both veins and arteries, effects that had been identified on the basis of light microscopic observations. Tortuosities and irregularly dilated vein segments were related to both aging and radiation changes but arterial stenosis was observed only in irradiated animals.

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Non-invasive translational Cynomolgus model for studying folliculogenesis and ovulation using color Doppler ultrasonography

Journal of Medical Primatology ◽

10.1111/j.1600-0684.2011.00514.x ◽

2011 ◽

Vol 41 (1) ◽

pp. 18-23 ◽

Cited By ~ 1

Author(s):

Harry A. van Diepen ◽

Jeffrey Pansier ◽

Paul Oude Wesselink ◽

Aric van Drie ◽

Marcel van Duin ◽

...

Keyword(s):

Doppler Ultrasonography ◽

Color Doppler ◽

Color Doppler Ultrasonography ◽

Non Invasive

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Retinal functional imager (RFI): Non-invasive functional imaging of the retina

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i2.8738 ◽

2013 ◽

Vol 5 (2) ◽

pp. 250-257 ◽

Cited By ~ 8

Author(s):

Sunil Ganekal

Keyword(s):

Functional Imaging ◽

Structural Changes ◽

Imaging System ◽

Retinal Blood Flow ◽

Capillary Perfusion ◽

Functional Changes ◽

Non Invasive ◽

Retinal Disorders ◽

Retinal Blood Flow Velocity ◽

Perfusion Maps

Retinal functional imager (RFI) is a unique non-invasive functional imaging system with novel capabilities for visualizing the retina. The objective of this review was to show the utility of non-invasive functional imaging in various disorders. Electronic literature search was carried out using the websites www.pubmed.gov and www.google.com. The search words were retinal functional imager and non-invasive retinal imaging used in combination. The articles published or translated into English were studied. The RFI directly measures hemodynamic parameters such as retinal blood-flow velocity, oximetric state, metabolic responses to photic activation and generates capillary perfusion maps (CPM) that provides retinal vasculature detail similar to flourescein angiography. All of these parameters stand in a direct relationship to the function and therefore the health of the retina, and are known to be degraded in the course of retinal diseases. Detecting changes in retinal function aid early diagnosis and treatment as functional changes often precede structural changes in many retinal disorders. Nepal J Ophthalmol 2013; 5(10): 250-257 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8738

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AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL

Indonesian Journal of Urology ◽

10.32421/juri.v21i1.7 ◽

2014 ◽

Vol 21 (1) ◽

Author(s):

Anton Hermawan ◽

Sabilal Alif ◽

Wahjoe Djatisoesanto ◽

Tri Wulanhandarini ◽

Budiono Budiono

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Color Doppler ◽

Resistive Index ◽

Renal Resistive Index ◽

Kidney Calculi ◽

Pelvic Kidney ◽

Extracorporeal Shock Wave ◽

Age Related

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.

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Diagnostic Performance of Oncuria™, a Urinalysis Test for Bladder Cancer

10.21203/rs.3.rs-253377/v1 ◽

2021 ◽

Author(s):

Yosuke Hirasawa ◽

Ian Pagano ◽

Runpu Chen ◽

Yijun Sun ◽

Yunfeng Dai ◽

...

Keyword(s):

Bladder Cancer ◽

Diagnostic Performance ◽

Clinical Laboratory ◽

Demographic Data ◽

Roc Curves ◽

Low Grade ◽

Linear Discriminant ◽

Non Invasive ◽

Diagnostic Panel ◽

Parallel Measurement

Abstract Background: Due to insufficient accuracy, urine-based assays currently have a limited role in the management of patients with bladder cancer. The identification of multiplex molecular signatures associated with disease has the potential to address this deficiency and to assist with accurate, non-invasive diagnosis and monitoring. Methods: To evaluate the performance of Oncuria™, a multiplex immunoassay for bladder detection in voided urine samples. The test was evaluated in a multi-institutional cohort of 362 prospectively collected subjects presenting for bladder cancer evaluation. The parallel measurement of 10 biomarkers (A1AT, APOE, ANG, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) was performed in an independent clinical laboratory. The ability of the test to identify patients harboring bladder cancer was assessed. Bladder cancer status was confirmed by cystoscopy and tissue biopsy. The association of biomarkers and demographic factors was evaluated using linear discriminant analysis (LDA) and predictive models were derived using supervised learning and cross-validation analyses. Diagnostic performance was assessed using ROC curves.Results: The combination of the 10 biomarkers provided an AUROC 0.93 [95% CI: 0.87 – 0.98], outperforming any single biomarker. The addition of demographic data (age, sex, and race) into a hybrid signature improved the diagnostic performance AUROC 0.95 [95% CI: 0.90 – 1.00]. The hybrid signature achieved an overall sensitivity of 0.93, specificity of 0.93, PPV of 0.65 and NPV of 0.99 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, MIBC and NMIBC were 0.94, 0.89, 0.97 and 0.93, respectively. Conclusions: Urinary levels of a biomarker panel enabled the accurate discrimination of bladder cancer patients and controls. The multiplex Oncuria™ test can achieve the efficient and accurate detection and monitoring of bladder cancer in a non-invasive patient setting.

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Comparative study of colour Doppler vs. FNNAC findings in WHO grade II thyroid enlargement in adult females

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192724 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1025

Author(s):

Sudhakar Rao M. S. ◽

Navneeth T. P. ◽

John C. J.

Keyword(s):

Pulsatility Index ◽

Low Cost ◽

Resistive Index ◽

Colour Doppler ◽

Who Grade ◽

Predictive Values ◽

Non Invasive ◽

Adult Females ◽

The Mean ◽

Sensitivity Specificity

Background: Thyroid gland disorders form one of the most common endocrinal and surgical problems encountered in clinical practice. FNNAC is widely accepted as the primary and better method than FNAC for investigation but has its disadvantages. Colour Doppler is a non-invasive, low cost, easily available and repeatable investigation with least patient discomfort and can be valuable in detection of benign and malignant thyroid enlargements.Methods: Forty cases of adult females with WHO grade 2 thyroid enlargement attending the department of otorhinolaryngology selected on simple random basis were included in this study. Following written consent, Colour Doppler scanning and FNNAC test were done on the thyroid swelling and the results were analysed. Results: The mean age of patients was 32.44 years. The mean age of malignancy was 44.66 years and showed statistically significant association. The Resistive and Pulsatility index and combination of both were found to have statistically significant results in detecting malignant and benign lesions The sensitivity, specificity, positive and negative predictive values of RI and PI were 83.33%, 94.12%, 71.43%, 96.97% and 50%, 94.12%, 60% and 91.43% respectively. On combining both the indices, the sensitivity was 91.67% and the positive predictive value was 97.06%.Conclusions: Colour Doppler can differentiate between benign and malignant thyroid enlargements using Resistive index (of>0.75) and Pulsatility Index (of>1.5) and can be a complementary diagnostic tool in the thyroid enlargement lesions, considering its accuracy, cost-effectiveness, easy availability and non-invasive repeatable nature.

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