Wang X, Yang R R, Yang Y T, Liu H J, Yan H
Department of Plastic Surgery and Burns, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
Zhonghua Shao Shang Za Zhi. 2020 Sep 20;36(9):853-860. doi: 10.3760/cma.j.cn501120-20190701-00288.
To observe the differences in normal facial skin thickness and echo density by different ages and sites of healthy adults of the same sex using 50 MHz high-frequency ultrasound. From January to June 2019, 200 healthy adult volunteers with normal facial skin who were from Sichuan, Yunnan, Guizhou, and Chongqing and met the inclusion criteria were recruited by the Affiliated Hospital of Southwest Medical University with simple random sampling method, and then were included in this cross-sectional investigation study. Then 50 MHz high-frequency ultrasound was used to obtain skin ultrasonogram of volunteers' forehead, canthus, eyelid, and cheek. According to the ages, 100 female volunteers were divided into 20-29 years old (30 females), 30-39 years old (25 females), 40-49 years old (20 females), and 50-70 years old (25 females) groups; 100 male volunteers were divided into 20-29 years old (30 males), 30-39 years old (25 males), 40-49 years old (20 males), and 50-70 years old (25 males) groups. The thickness of full-skin, the upper dermal echo density, and the lower dermal echo density of the female and male volunteers'forehead, canthus, eyelid, and cheek were recorded respectively. Data were statistically analyzed with one-way analysis of variance, analysis of variance for repeated measurement, least significant difference test, and Bonferroni correction. (1) The thickness of full-thickness skin in forehead, canthus, eyelid, and cheek of female and male volunteers in 20-29 years old group were (1.86±0.26), (1.36±0.11), (1.24±0.25), and (1.90±0.21) mm, (2.45±0.37), (1.64±0.19), (1.44±0.16), and (2.53±0.26) mm, respectively, in 30-39 years old group were (1.98±0.24), (1.43±0.13), (1.15±0.15), and (2.12±0.13) mm, (2.34±0.27), (1.63±0.27), (1.50±0.38), and (2.43±0.40) mm, respectively, in 40-49 years old group were (1.90±0.21), (1.43±0.18), (1.24±0.27), and (1.98±0.12) mm, (2.14±0.24), (1.54±0.25), (1.28±0.14), and (2.39±0.36) mm, respectively, in 50-70 years old group were (1.64±0.25), (1.36±0.19), (1.16±0.12), and (1.89±0.29) mm, (2.28±0.27), (1.73±0.25), (1.58±0.18), and (2.38±0.32) mm, respectively. There were no statistically significant differences between female volunteers in the 4 groups and male volunteers in the 4 groups in thickness of full-thickness skin in canthus, eyelid, and cheek (=0.677, 0.666, 0.136, 0.697, 0.294, 0.888, >0.05). The thickness of full-thickness skin in forehead and cheek of the female volunteers in the 4 groups and male volunteers in the 4 groups was similar (>0.05), and was significantly higher than that of canthus and eyelid (<0.05). The thickness of full-thickness skin in canthus and eyelid of female volunteers in 20-29 years old, 40-49 years old, and 50-70 years old group was similar (>0.05), while thickness of full-thickness skin in canthus and eyelid of male volunteers in the 4 groups was similar (>0.05). (2) The upper dermal echo density of forehead, canthus, eyelid, and cheek of female volunteers in 50-70 years old group was significantly lower than that in 20-29 years old and 30-39 years old groups (<0.05). The upper dermal echo density of forehead, canthus, eyelid, and cheek of male volunteers in 50-70 years old group was significantly lower than that in 20-29 years old group (<0.05). The upper dermal echo density of forehead, canthus, eyelid, and cheek of female and male volunteers in 20-29 years old and 30-39 years old groups was similar (>0.05). The upper dermal echo density of forehead and cheek of female volunteers in 20-29 years old, 40-49 years old, and 50-70 years old groups was significantly lower than that of canthus and eyelid (<0.05). The echo density of upper dermis of cheek of male volunteers in the 4 groups was significantly lower than that of canthus and eyelid (<0.05). The upper dermal echo density of canthus and eyelid of female volunteers in the 4 groups and male volunteers in the 4 groups was similar (>0.05), the upper dermal echo density of forehead and cheek was similar (>0.05). (3) The lower dermal echo density of forehead, canthus, eyelid, and cheek of female volunteers in 50-70 years old group was significantly higher than that in 20-29 years old and 30-39 years old groups (<0.05). The lower dermal echo density of forehead, canthus, eyelid, and cheek of male volunteers in 50-70 years old group was significantly higher than that in 20-29 years old group (<0.05). The echo density of the lower dermis of forehead, eyelid, and cheek of female and male volunteers in 20-29 years old, 30-39 years old, and 40-49 years old groups was similar (>0.05). The lower dermal echo density of forehead and cheek of female volunteers in the 4 groups was significantly lower than that of canthus and eyelid (<0.05). The lower dermal echo density of forehead and cheek of male volunteers in 30-39 years old, 40-49 years old, and 50-70 years old groups was significantly lower than that of canthus and eyelid (<0.05). The lower dermal echo density between canthus and eyelid and between forehead and check of female volunteers in the 4 groups and male volunteers in the 4 groups was similar (>0.05). The 50 MHz high-frequency ultrasonography shows that the thickness of full-thickness skin of canthus, eyelid, and cheek is similar in all age groups of female and male adult volunteers with normal facial skin. In the same age group, the thickness of full-thickness skin of forehead and cheek of male and female volunteers is significantly higher than that of canthus and eyelid. The upper dermal echo density of forehead, canthus, eyelid, and cheek of female and male volunteers shows a decreasing trend with age, while the lower dermal echo density shows an increasing trend with age. In addition, the echo density of upper and lower dermis of canthus and eyelid was significantly higher than that of cheek in all the four age groups.
采用50MHz高频超声观察同性别健康成年人不同年龄及部位正常面部皮肤厚度及回声密度的差异。2019年1月至6月,西南医科大学附属医院采用简单随机抽样方法招募了200名来自四川、云南、贵州和重庆且面部皮肤正常并符合纳入标准的健康成年志愿者,将其纳入本横断面调查研究。然后用50MHz高频超声获取志愿者前额、眼角、眼睑和脸颊的皮肤超声图像。根据年龄,将100名女性志愿者分为20 - 29岁(30名女性)、30 - 39岁(25名女性)、40 - 49岁(20名女性)和50 - 70岁(25名女性)组;100名男性志愿者分为20 - 29岁(30名男性)、30 - 39岁(25名男性)、40 - 49岁(20名男性)和50 - 70岁(25名男性)组。分别记录女性和男性志愿者前额、眼角、眼睑和脸颊的全层皮肤厚度、真皮上层回声密度和真皮下层回声密度。数据采用单因素方差分析、重复测量方差分析、最小显著差异检验和Bonferroni校正进行统计学分析。(1)20 - 29岁组女性和男性志愿者前额、眼角、眼睑和脸颊的全层皮肤厚度分别为(1.86±0.26)、(1.36±0.11)、(1.24±0.25)和(1.90±0.21)mm,(2.45±0.37)、(1.64±0.19)、(1.44±0.16)和(2.53±0.26)mm;30 - 39岁组分别为(1.98±0.24)、(1.43±0.13)、(1.15±0.15)和(2.12±0.13)mm,(2.34±0.27)、(1.63±0.27)、(1.50±0.38)和(2.43±0.40)mm;40 - 49岁组分别为(1.90±0.21)、(1.43±0.18)、(1.24±0.27)和(1.98±0.12)mm,(2.14±0.24)、(1.54±0.25)、(1.28±0.14)和(2.39±0.36)mm;50 - 70岁组分别为(1.64±0.25)、(1.36±0.19)、(1.16±0.12)和(1.89±0.29)mm,(2.28±0.27)、(1.73±0.25)、(1.58±0.18)和(2.38±0.32)mm。4组女性志愿者与4组男性志愿者眼角、眼睑和脸颊的全层皮肤厚度差异无统计学意义(=0.677,0.666,0.136,0.697,0.294,0.888,>0.05)。4组女性志愿者与4组男性志愿者前额和脸颊的全层皮肤厚度相似(>0.05),且显著高于眼角和眼睑(<0.05)。20 - 29岁、40 - 49岁和50 - 70岁组女性志愿者眼角和眼睑的全层皮肤厚度相似(>0.05),4组男性志愿者眼角和眼睑的全层皮肤厚度相似(>0.05)。(2)50 - 70岁组女性志愿者前额、眼角、眼睑和脸颊的真皮上层回声密度显著低于20 - 29岁和30 - 39岁组(<0.05)。50 - 70岁组男性志愿者前额、眼角、眼睑和脸颊的真皮上层回声密度显著低于20 - 29岁组(<0.05)。20 - 29岁和30 - 39岁组女性和男性志愿者前额、眼角、眼睑和脸颊的真皮上层回声密度相似(>0.05)。20 - 29岁、40 - 49岁和50 - 70岁组女性志愿者前额和脸颊的真皮上层回声密度显著低于眼角和眼睑(<0.05)。4组男性志愿者脸颊的真皮上层回声密度显著低于眼角和眼睑(<0.05)。4组女性志愿者与4组男性志愿者眼角和眼睑的真皮上层回声密度相似(>0.05),前额和脸颊的真皮上层回声密度相似(>0.05)。(3)50 - 70岁组女性志愿者前额、眼角、眼睑和脸颊的真皮下层回声密度显著高于20 - 29岁和30 - 39岁组(<0.05)。50 - 70岁组男性志愿者前额、眼角、眼睑和脸颊的真皮下层回声密度显著高于20 - 29岁组(<0.05)。20 - 29岁、30 - 39岁和40 - 49岁组女性和男性志愿者前额、眼睑和脸颊的真皮下层回声密度相似(>0.05)。4组女性志愿者前额和脸颊的真皮下层回声密度显著低于眼角和眼睑(<0.05)。30 - 39岁、40 - 49岁和50 - 70岁组男性志愿者前额和脸颊的真皮下层回声密度显著低于眼角和眼睑(<0.05)。4组女性志愿者与4组男性志愿者眼角与眼睑之间以及前额与脸颊之间的真皮下层回声密度相似(>0.05)。50MHz高频超声显示,面部皮肤正常的成年女性和男性志愿者各年龄组眼角、眼睑和脸颊的全层皮肤厚度相似。在同一年龄组中,男性和女性志愿者前额和脸颊的全层皮肤厚度显著高于眼角和眼睑。女性和男性志愿者前额、眼角、眼睑和脸颊的真皮上层回声密度随年龄呈下降趋势,而真皮下层回声密度随年龄呈上升趋势。此外,在所有四个年龄组中,眼角和眼睑的真皮上下层回声密度均显著高于脸颊。