Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Ultrasound Med Biol. 2020 May;46(5):1169-1178. doi: 10.1016/j.ultrasmedbio.2020.01.010. Epub 2020 Feb 13.
This study was aimed at investigating the value of shear wave elastography (SWE) in quantitative evaluation of keloids. A total of 87 patients with 139 keloids were enrolled. Vancouver scar scale (VSS) scores were recorded. Thickness and blood flow grade were evaluated using high-frequency ultrasound. Skin stiffness (mean speed of shear wave, C) was evaluated using SWE in both transverse and longitudinal sections. All measurements were performed in both keloids and site-matched unaffected skin (normal controls). The reliability of measurements was evaluated using intra- and inter-class correlation coefficients by two observers. Inter- and intra-observer repeatability was excellent (correlation coefficient > 0.99, p < 0.01). The SWE results revealed a significant increase in C in keloids (p < 0.001) compared with the normal controls. C in the longitudinal section was greater than that in the transverse section for keloids (p < 0.001). C was highly positively correlated with VSS score (r = 0.904, p < 0.001), moderately positively correlated with thickness (r = 0.490, p < 0.001) and less positively correlated with blood flow (r = 0.231, p < 0.01). This non-invasive, tolerable and convenient imaging technique could be an effective tool for objectively evaluating keloid stiffness in the future, thus laying a foundation for the treatment and evaluation of keloids.
本研究旨在探讨剪切波弹性成像（SWE）在定量评估瘢痕疙瘩中的价值。共纳入 87 例 139 个瘢痕疙瘩患者。记录温哥华瘢痕量表（VSS）评分。采用高频超声评估厚度和血流分级。采用 SWE 在横切面和纵切面评估皮肤硬度（剪切波平均速度，C）。在瘢痕疙瘩和部位匹配的正常皮肤（正常对照）中均进行所有测量。两名观察者采用组内相关系数和组间相关系数评估测量的可靠性。组内和组间重复性均极好（相关系数>0.99，p<0.01）。SWE 结果显示，与正常对照组相比，瘢痕疙瘩的 C 值显著增加（p<0.001）。瘢痕疙瘩的纵切面 C 值大于横切面（p<0.001）。C 值与 VSS 评分高度正相关（r=0.904，p<0.001），与厚度中度正相关（r=0.490，p<0.001），与血流相关性较低（r=0.231，p<0.01）。这种非侵入性、可耐受和方便的成像技术可能是未来客观评估瘢痕疙瘩硬度的有效工具，为瘢痕疙瘩的治疗和评估奠定基础。
