Agabalyan Natacha A, Su Samuel, Sinha Sarthak, Gabriel Vincent
Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada.
Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada; Division of Physical Medicine and Rehabilitation, Departments of Clinical Neurosciences, Surgery and Pediatrics, Alberta Children's Hospital Research Institute, Firefighters' Burn Treatment Centre, University of Calgary, Canada.
Burns. 2017 May;43(3):531-538. doi: 10.1016/j.burns.2016.09.008. Epub 2017 Jan 18.
Current methods for evaluating scar tissue volume following burns have shortcomings. The Vancouver Burn Scar scale is subjective, leading to a high variability in assessment. Although histological assessment via punch biopsy can discriminate between the different layers of skin, such an approach is invasive, inefficient, and detrimental to patient experience and wound healing. This study investigates the accuracy of high-frequency ultrasonography, a non-invasive alternative to histology, for measuring dermal and epidermal thickness in scar tissue.
Scar thicknesses of 10 patients following burns were assessed using a 2-D high-frequency ultrasound probe. The scars were then biopsied using a circular 4mm punch biopsy for histological assessment. Dermal, epidermal, and total thickness of the scar tissue was measured using ultrasound and histology, and correlations between the two measurements were calculated.
There was not a strong correlation between ultrasound measurement and histological analysis for epidermal, dermal, and total thickness (Spearman's rank correlation of -0.1223, -0.6242, and -0.6242) of scar tissue.
Measurements of scar thickness using high-frequency ultrasonography did not recapitulate the in vivo dermal, epidermal and total thickness. Based on these findings, strategies for further optimization of 2-D ultrasonography is discussed before clinical and research use.
目前评估烧伤后瘢痕组织体积的方法存在缺陷。温哥华烧伤瘢痕量表具有主观性，导致评估的变异性很大。虽然通过打孔活检进行组织学评估可以区分皮肤的不同层次，但这种方法具有侵入性、效率低，且对患者体验和伤口愈合有害。本研究调查了高频超声检查（一种组织学的非侵入性替代方法）测量瘢痕组织中真皮和表皮厚度的准确性。
使用二维高频超声探头评估10例烧伤患者的瘢痕厚度。然后使用直径4mm的圆形打孔活检对瘢痕进行取材，以进行组织学评估。使用超声和组织学方法测量瘢痕组织的真皮、表皮和总厚度，并计算两种测量方法之间的相关性。
瘢痕组织的表皮、真皮和总厚度的超声测量与组织学分析之间没有很强的相关性（Spearman等级相关性分别为-0.1223、-0.6242和-0.6242）。
使用高频超声测量瘢痕厚度不能重现体内真皮、表皮和总厚度。基于这些发现，在临床和研究应用之前，讨论了进一步优化二维超声检查的策略。
