Perth Scar and Pain Clinic, Fremantle, Western Australia 6160, Australia; School of Medical and Health Science, Edith Cowan University, Joondalup, Western Australia 6027, Australia; BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, University of Western Australia, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia.
Department of Medical Imaging, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia.
Ultrasound Med Biol. 2020 Jul;46(7):1614-1629. doi: 10.1016/j.ultrasmedbio.2020.03.003. Epub 2020 May 5.
The aim of this research was to investigate the use of shear wave elastography as a novel tool to quantify and visualize scar stiffness after a burn. Increased scar stiffness is indicative of pathologic scarring which is associated with persistent pain, chronic itch and restricted range of movement. Fifty-five participants with a total of 96 scars and 69 contralateral normal skin sites were evaluated. A unique protocol was developed to enable imaging of the raised and uneven burn scars. Intra-rater and inter-rater reliability was excellent (intra-class correlation coefficient >0.97), and test-retest reliability was good (intra-class correlation coefficient >0.85). Shear wave elastography was able to differentiate between normal skin, pathologic scars and non-pathologic scars, with preliminary cutoff values identified. Significant correlations were found between shear wave velocity and subjective clinical scar assessment (r = 0.66). Shear wave elastography was able to provide unique information associated with pathologic scarring and shows promise as a clinical assessment and research tool.
本研究旨在探讨剪切波弹性成像作为一种新的工具,用于量化和可视化烧伤后的疤痕硬度。疤痕硬度增加表明病理性瘢痕形成,与持续性疼痛、慢性瘙痒和运动范围受限有关。共评估了 55 名参与者的 96 处疤痕和 69 处对侧正常皮肤部位。开发了一种独特的方案,以实现对凸起和不均匀烧伤疤痕的成像。内部观察者和外部观察者的可靠性均非常好(组内相关系数>0.97),且测试-重测可靠性良好(组内相关系数>0.85)。剪切波弹性成像能够区分正常皮肤、病理性疤痕和非病理性疤痕,并确定了初步的截断值。剪切波速度与主观临床疤痕评估之间存在显著相关性(r=0.66)。剪切波弹性成像能够提供与病理性瘢痕相关的独特信息,有望成为一种临床评估和研究工具。
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