Zhou Li, Zhou Qin, Zheng Chenxi, Wang Zhigang, Rao Maohua
Department of Ultrasound, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Department of Clinical Nutrition, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Sci Rep. 2025 Mar 12;15(1):8568. doi: 10.1038/s41598-025-91111-y.
The current understanding and a standardized assessment or treatment guidelines for keloids are not fully established, highlighting the need for an objective method to gauge keloid severity and treatment outcomes. This study investigated the clinical utility of multimodal ultrasound, integrating Shear Wave Elastography (SWE) and Angio planewave ultrasensitive imaging (AP), to assess keloid severity and treatment responses in 58 keloids across 31 patients. Keloids were categorized into mild, moderate, and severe based on Vancouver Scar Scale (VSS) scores. The results revealed significant differences in keloid thickness, elasticity parameters, and blood flow levels among severity groups, with the AP technique demonstrated superior sensitivity in detecting keloid microcirculation. Additionally, the study evaluated the therapeutic response to Strontium-90 Yttrium-90 isotope applicator treatment in 28 keloids, categorizing them into 13 good responders and 15 poor responders based on improvements observed in their VSS scores. Good responders demonstrated marked improvements post-treatment, including significant flattening of the keloids, decreased stiffness, and normalization of blood flow levels. In contrast, poor responders exhibited minimal changes in keloid thickness, stiffness, and blood flow signals following treatment. These findings underscore the effectiveness of multimodal ultrasound in evaluating treatment responses in keloid management. In conclusion, multimodal ultrasound, focusing on SWE and AP modalities, offers a promising tool for comprehensive assessment, with potential to enhance keloid evaluation and track treatment responses across varying therapeutic interventions, thereby facilitating optimized clinical management and guiding personalized treatment. The study was successfully registered on ClinicalTrials.gov on 12/09/2023, with the Identifier NCT06034587.
目前对于瘢痕疙瘩的认识以及标准化评估或治疗指南尚未完全确立，这凸显了需要一种客观方法来衡量瘢痕疙瘩的严重程度和治疗效果。本研究调查了多模态超声（整合剪切波弹性成像（SWE）和血管平面波超灵敏成像（AP））在评估31例患者的58个瘢痕疙瘩严重程度和治疗反应方面的临床效用。根据温哥华瘢痕量表（VSS）评分，将瘢痕疙瘩分为轻度、中度和重度。结果显示，不同严重程度组之间在瘢痕疙瘩厚度、弹性参数和血流水平上存在显著差异，AP技术在检测瘢痕疙瘩微循环方面表现出更高的敏感性。此外，该研究评估了28个瘢痕疙瘩对锶-90钇-90同位素敷贴器治疗的反应，根据VSS评分的改善情况将其分为13个良好反应者和15个不良反应者。良好反应者在治疗后表现出明显改善，包括瘢痕疙瘩明显变平、硬度降低和血流水平恢复正常。相比之下，不良反应者在治疗后瘢痕疙瘩厚度、硬度和血流信号变化极小。这些发现强调了多模态超声在评估瘢痕疙瘩治疗反应方面的有效性。总之，聚焦于SWE和AP模式的多模态超声为全面评估提供了一种有前景的工具，有可能加强瘢痕疙瘩评估并跟踪不同治疗干预的治疗反应，从而促进优化临床管理并指导个性化治疗。该研究于2023年9月12日成功在ClinicalTrials.gov上注册，标识符为NCT06034587。
