激光散斑衬比成像观察硬皮病手指溃疡肉毒素A治疗前后血流变化

Using Laser Speckle Contrast Imaging to Assess the Blood Flow Changes in Finger Ulcer Preand Post-Botulinum Toxin A Treatment in a Patient with Systemic Sclerosis

目的探讨激光散斑衬比成像技术(laser speckle contrast imaging,LSCI)在观察系统性硬皮病手指溃疡肉毒素A治疗前后血流变化中的作用。方法患者手指溃疡处接受肉毒素A 20U注射前后均进行LSCI观察。结果治疗前LSCI显示右手拇指溃疡部位可见明显的血流缺损区,形状不规则,平均血流速指数:65(PU)。治疗3个月后患者随访,右手拇指溃疡面肉眼愈合,LSCI示患指中血流缺损区面积明显减小,血流速指数:90(PU)。结论 LSCI可实时动态监测手指溃疡血流情况,指导临床医师的病情评估和诊疗。

Objective To validate the application of laser speckle contrast imaging in assessing the blood flow changes in finger ulcer before and after botulinum toxin A treatment in a patient with systemic sclerosis. Methods Blood flow changes in finger ulcer of a patient with systemic sclerosis were evaluated with LSCI before and after injection of the 20U botulinum toxin A. Results Before the treatment,LSCI showed irregular hy- poperfusion on the right thumb, with mean flow index of 65 （PU）. Three months after treatment, thumb ulcer was healed, accompanied by a reduction in hypoperfusion are- a and an increased mean flow index 90 （PU）. Conclusion LSCI can monitor the blood flow changes in digital ulcer dynamically and could be used to objectively assess disease status and therapeutic efficacy in addition to facilitating diagnosis.