鲜红斑痣多模态超声表现及在光动力疗效评估中的应用研究  

Multimodal ultrasound manifestations of port-wine stains and their application in efficacy assessment of photodynamic therapy

作　　者：向茜[1] 张凌燕[1] 钟琳[1] 高奕 邱逦[1] Xiang Xi;Zhang Lingyan;Zhong Lin;Gao Yi;Qiu Li(Department of Medical Ultrasound,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院超声医学科,成都610041

出　　处：《中华皮肤科杂志》2024年第9期801-806,共6页Chinese Journal of Dermatology

基　　金：国家自然科学基金(82272003);四川省科技计划项目(2022YFH0099)。

摘　　要：目的利用多模态超声综合评估不同临床分型鲜红斑痣皮肤层厚度、血流评级、硬度值以及治疗后各超声指标的变化,探讨多模态超声在鲜红斑痣定量评估以及疗效评估中的应用价值。方法本研究为观察性研究。共纳入298例鲜红斑痣患者,使用高频超声测量皮损厚度以及血流信号,剪切波弹性成像测量皮肤层杨氏模量最大值(Emax)及剪切波传播速度最大值(Cmax),比较各超声指标与病变对侧或周围正常皮肤之间的差异。对行光动力治疗后的124例患者进行再次超声评估,比较各指标治疗前后的变化。使用t检验、方差分析及秩和检验进行统计分析。结果粉红型鲜红斑痣(106例)皮肤厚度(1.41±0.28)mm,血流评级以0级为主(81%),Emax(16.24±1.82)kPa,Cmax(2.28±0.09)m/s,各指标与正常皮肤以及治疗后的皮肤比较,差异均无统计学意义(P>0.05)。紫红型鲜红斑痣(121例)皮肤厚度(1.86±0.23)mm,血流评级以1级为主(45%),且均高于正常皮肤;治疗后皮肤厚度、血流信号评级均降低(P<0.05);Emax(16.41±1.82)kPa、Cmax(2.32±0.13)m/s与正常皮肤及治疗后皮肤比较,差异均无统计学意义(P>0.05)。增厚型鲜红斑痣(71例)皮肤厚度(2.51±0.32)mm,血流评级以3级为主(55%),Emax(22.22±2.46)kPa,Cmax(2.75±0.11)m/s,均高于正常皮肤(P<0.05);治疗后各指标均降低。结论多模态超声可用于定量评估不同临床分型鲜红斑痣及其治疗效果,紫红型和增厚型鲜红斑痣皮肤层更厚以及血流评级更高,增厚型鲜红斑痣皮肤硬度值更高,各超声指标在治疗后均可降低。Objective To comprehensively evaluate the skin thickness,blood flow grades,skin stiffness,and post-treatment changes in ultrasound indices in patients with different clinical types of port-wine stains(PWS)by multimodal ultrasound,and to explore the application value of multimodal ultrasound in the quantitative evaluation of and efficacy assessment for PWS.Methods An observational study was conducted,including 298 patients with PWS.High-frequency ultrasound was used to measure the thickness of and blood flow signals in skin lesions,and shear wave elastography to measure the maximum Young's modulus(Emax)and maximum shear wave propagation velocity(Cmax)of the skin layers.Differences in various ultrasound indices were analyzed between skin lesions and surrounding normal skin.After photodynamic therapy,ultrasound re-evaluation was performed on 124 patients to analyze changes in ultrasound indices before and after treatment.Statistical analysis was conducted using t test,analysis of variance,and rank sum test.Results In 106 patients with pink PWS,the skin thickness was 1.41±0.28 mm,the blood flow was mainly rated as grade 0(81%),the Emax was 16.24±1.82 kPa,and the Cmax was 2.28±0.09 m/s.There were no significant differences in the above indices between normal skin and treated skin(all P>0.05).In the 121 patients with purplish red PWS,the skin thickness was 1.86±0.23 mm;the blood flow was mainly rated as grade 1(45%),which was higher than that of normal skin;after treatment,both the skin thickness and blood flow grades were decreased(P<0.05);there were no significant differences in the Emax and Cmax between purplish red PWS lesions(16.41±1.82 kPa,2.32±0.13 m/s,respectively)and normal skin or treated skin(all P>0.05).In the 71 patients with thickened PWS,the skin thickness was 2.51±0.32 mm,the blood flow was mainly trated as grade 3(55%),the Emax was 22.22±2.46 kPa,and the Cmax was 2.75±0.11 m/s,which were all significantly higher than those of normal skin(all P<0.05);all the indices were decreased after treatme

关 键 词：葡萄酒色痣 超声检查 多普勒 弹性成像技术 光动力治疗 多模态超声 剪切波弹性成像 

分 类 号：R758.51[医药卫生—皮肤病学与性病学] R445.1[医药卫生—临床医学]