Department of Radiology, The First Hospital of Soochow University, Suzhou, China.
Department of Dermatology, The First Hospital of Soochow University, Suzhou, China.
Skin Res Technol. 2023 Jul;29(7):e13393. doi: 10.1111/srt.13393.
No previous study investigated the anatomical changes of the scalp and hair follicles between tertiary androgenetic alopecia and severe alopecia areata using high-resolution magnetic resonance imaging (HR-MRI). This study aimed to explore the value of HR-MRI in assessing alopecia.
Forty-eight people were included in this study. The imaging indicators of the vertex and occipital scalp were recorded and compared. The logistic regression model was developed for the indicators that differed between tertiary androgenetic alopecia and severe alopecia areata. The receiver-operating characteristic (ROC) curve was used to assess the diagnostic efficacy of the model for tertiary androgenetic alopecia and severe alopecia areata.
At the vertex, the thickness of the subcutaneous tissue layer, follicle depth, relative follicle depth, total number of follicles within a 2-cm distance, and number of strands reaching the middle and upper third of the subcutaneous fat layer within a 2-cm distance were statistically different between patients with tertiary androgenetic alopecia, those with severe alopecia areata, and healthy volunteers (p < 0.05). The logistic regression model suggested that the subcutaneous tissue layer thickness was important in discriminating tertiary androgenetic alopecia from severe alopecia areata. The ROC curve showed that the area under the curve, sensitivity, specificity, and best cutoff values of the subcutaneous tissue layer were 0.886, 94.4%, 70%, and 4.31 mm, respectively.
HR-MRI can observe the changes in anatomical structures of the scalp and hair follicles in patients with alopecia. HR-MRI can be applied to the differential diagnosis of tertiary androgenetic alopecia and severe alopecia areata.
既往研究尚未应用高分辨率磁共振成像（HR-MRI）探讨三级雄激素性脱发和严重斑秃头皮及毛囊的解剖学变化。本研究旨在探讨 HR-MRI 在评估脱发中的应用价值。
本研究共纳入 48 例患者，记录并比较头皮顶点和枕部的影像学指标。采用逻辑回归模型对三级雄激素性脱发和严重斑秃之间存在差异的指标进行分析，采用受试者工作特征（ROC）曲线评估该模型对三级雄激素性脱发和严重斑秃的诊断效能。
在头皮顶点，三级雄激素性脱发、严重斑秃与健康志愿者之间，皮下组织层厚度、毛囊深度、相对毛囊深度、2 cm 内的毛囊总数、2 cm 内到达皮下脂肪中层和上层的发束数等指标均存在统计学差异（p<0.05）。逻辑回归模型提示，皮下组织层厚度在鉴别三级雄激素性脱发和严重斑秃中具有重要意义。ROC 曲线显示，皮下组织层厚度的曲线下面积、敏感度、特异度及最佳截断值分别为 0.886、94.4%、70%和 4.31 mm。
HR-MRI 可观察脱发患者头皮及毛囊解剖结构的变化，可应用于三级雄激素性脱发和严重斑秃的鉴别诊断。
