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- Emrani, Zahra, et al.
(author)
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Capillary density : An important parameter in nailfold capillaroscopy
- 2017
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In: Microvascular Research. - Netherland : Elsevier. - 0026-2862 .- 1095-9319. ; 109, s. 7-18
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Journal article (peer-reviewed)abstract
- Nailfold capillaroscopy is one of the various noninvasive bioengineering methods used to investigate skin microcirculation. It is an effective examination for assessing microvascular changes in the peripheral circulation; hence it has a significant role for the diagnosis of Systemic sclerosis with the classic changes of giant capillaries as well as the decline in capillary density with capillary dropout. The decline in capillary density is one of microangiopathic features existing in connective tissue disease. It is detectable with nailfold capillaroscopy. This parameter is assessed by applying quantitative measurement. In this article, we reviewed a common method for calculating the capillary density and the relation between the number of capillaries as well as the existence of digital ulcers, pulmonary arterial hypertension, autoantibodies, scleroderma patterns and different scoring system.
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- Etehad Tavakol, Mahnaz, et al.
(author)
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Nailfold Capillaroscopy in Rheumatic Diseases : Which Parameters Should Be Evaluated?
- 2015
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In: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141. ; 2015
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Journal article (peer-reviewed)abstract
- Video nailfold capillaroscopy (NFC), considered as an extension of the widefield technique, allows a more accurate measuring andstoring of capillary data and a better defining, analyzing, and quantifying of capillary abnormalities. Capillaroscopic study is oftenperformed on the patients suspected of having microcirculation problems such as Raynaud’s phenomenon as the main indicationfor nailfold capillaroscopy. Capillaroscopic findings based on microcirculation studies can provide useful information in the fieldsof pathophysiology, differential diagnosis, and monitoring therapy. Nailfold capillaroscopy provides a vital assessment in clinicalpractices and research; for example, its reputation in the early diagnosis of systemic sclerosis is well established and it is also usedas a classification criterion in this regard. This review focuses on the manner of performing video nailfold capillaroscopy and on acommon approach for measuring capillary dimensions in fingers and toes.
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- Fatemi, Alimohammad, et al.
(author)
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Nailfold microvascular changes in patients with systemic lupus erythematosus and their associative factors
- 2019
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In: Microvascular Research. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0026-2862 .- 1095-9319. ; 126
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to determine capillaroscopic changes in patients with systemic lupus erythematosus (SLE) and their predictors. Methods: Fifty-nine SLE patients and 31 controls were enrolled in a cross-sectional study. Nailfold capillaroscopy examinations were performed, and qualitative semi-quantitative and quantitative parameters were evaluated in all fingers. Demographic features and lupus characteristics, such as renal involvement, medications, laboratory data, disease activity (SLEDAI) and damage, were recorded. The predictors of capillaroscopic abnormalities were obtained by backward stepwise regression analysis. Results: Capillary numbers of right hands were significantly lower in patients than in controls [8.74 (1.66) vs. 9.63 (1.80), P = 0.0001]. Capillaries were wider in patients than in controls in right [56.32 pm (16.76) vs. 50.43 mu m (10.16), P = 0.002] and left hands [54.40 (15.02) vs. 49.71 (9.77), P = 0.005]. Capillaries were shorter in SLE patients than in controls. Multivariate analysis revealed that the main associative factors of microvascular abnormalities were gender, drinking tea and hydroxychloroquine use for giant capillaries, SLEDAI and low C3 for avascularity and age, lupus nephritis and corticosteroid use for ramification. Conclusion: Most nailfold capillaroscopic abnormalities were more common in SLE patients than in controls. Hydroxychloroquine, corticosteroids, SLEDAI, low complement and lupus nephritis may be the major prognostic factors for microvascular changes in SLE patients.
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- Karbalaie, Abdolamir, 1970-, et al.
(author)
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Counting Capillaries in Nailfold Capillaroscopy:State of the Art and a Proposed Method
- 2016
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In: 2016 IEEE EMBS CONFERENCE ON BIOMEDICAL ENGINEERING AND SCIENCES (IECBES). - : IEEE. ; , s. 170-174
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Conference paper (peer-reviewed)abstract
- Capillaries play a crucial role in the microcirculatory system by exchanging metabolic substrates and waste products between blood and various tissues. The behavior of capillaries is affiliated with the number of capillaries per unit volume of tissue. Among the various noninvasive techniques available for analyzing skin microcirculation, nailfold capillaroscopyis considered to be a simple and easy-to-perform technique that allows a direct in-vivo visualization of the capillary network.Capillary density is one of the most important parameters in the studies involving capillaroscopy images. Capillary density in most of studies is defined as the number of capillaries in a one-millimeter span of the distal row in each finger or toe. This definition is silent about counting or excluding the number of the capillary with different shapes. However, there is no single standard for counting the number of capillaries in a span of one millimeter. In this paper, a novel method is proposed for determining the nailfold capillary density. This method is a modified combination of two existing techniques: the direct observation and the 90◦ method.Compared to the two existing approaches, the proposed method is more straightforward and easy to use for cases in which the capillaries have different shapes and sizes. Through different examples, we have shown how this method can be used to select the apex point of the capillary and subsequently count the number of capillaries with several papillae.
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6. |
- Karbalaie, Abdolamir, 1975-, et al.
(author)
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Image Enhancement Effect on Inter and Intra-observer Reliability of Nailfold Capillary Assessment
- 2018
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In: Microvascular Research. - : Elsevier. - 0026-2862 .- 1095-9319.
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Journal article (peer-reviewed)abstract
- Background: Nailfold capillaroscopy (NC) is a diagnostic imaging technique that is used to assess the blood capillary network in the nailfold area. NC is routinely used for patients with microcirculation problems, such as systemic sclerosis and other connective tissue diseases. Experts commonly use subjective evaluation as a reference point in images of nailfold video capillaroscopy, so it is important to reduce the inherent ambiguities in human judgment and diagnosis. Image quality is an important factor that affects measurement error and assessment time of NC images.Objective: In this study, a new image enhancement technique was introduced and evaluated subjectively.Methods: In total, 475 nailfold video capillaroscopy images from 18 healthy subjects and 41 systemic lupus erythematosus patients were used. The images were randomly divided into two sets, one each with 275 and 200. Eight independent observers who were familiar with the capillaroscopy technique participated in this study. The set of 275 images was evaluated by three observers with the forced–choice pairwise comparison method. Elliptic broken line (EBL) was used to count the number of capillaries. The intra- and inter-observer reliability of the original and enhanced images was evaluated on 200 images by five observers.Result: Except for eight images, all observers preferred the enhanced images in the visual quality comparison method. The intra-class correlation coefficient (ICC) of intra- and inter-observer reliability increased from 0.76-0.84 to 0.82-0.89, respectively, when using the enhancement method.Conclusion: By improving the image quality, more capillary details will be visible, and an observer can document more details that may not be visible in the original image and can do so more efficiently.
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7. |
- Karbalaie, Abdolamir, 1975-, et al.
(author)
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Practical issues in assessing nailfold capillaroscopic images : a summary
- 2019
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In: Clinical Rheumatology. - : Springer. - 0770-3198 .- 1434-9949. ; 38:9, s. 2343-2354
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Journal article (peer-reviewed)abstract
- Nailfold capillaroscopy (NC) is a highly sensitive, safe, and non-invasive technique to assess involvement rate of microvascularity in dermatomyositis and systemic sclerosis. A large number of studies have focused on NC pattern description, classification, and scoring system validation, but minimal information has been published on the accuracy and precision of the measurement. The objective of this review article is to identify different factors affecting the reliability and validity of the assessment in NC. Several factors can affect the reliability of the examination, e.g., physiological artifacts, the nailfold imaging instrument, human factors, and the assessment rules and standards. It is impossible to avoid all artifacts, e.g., skin transparency, physically injured fingers, and skin pigmentation. However, minimization of the impact of some of these artifacts by considering some protocols before the examination and by using specialized tools, training, guidelines, and software can help to reduce errors in the measurement and assessment of NC images. Establishing guidelines and instructions for automatic characterization and measurement based on machine learning techniques also may reduce ambiguities and the assessment time.
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