高频超声联合剪切波弹性成像评估寻常痤疮的临床价值  

Clinical value of high-frequency ultrasound combined with shear wave elastography in the evaluation of acne vulgaris

作　　者：张炜阳[1] 陈飞[1] 王惠[1] 杨贝 ZHANG Weiyang;CHEN Fei;WANG Hui;YANG Bei(Department of Ultrasound Medicine,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Dermatology,Xi’an Ninth Hospital,Xi’an 710000,China)

机构地区：[1]兰州大学第一医院超声医学科,甘肃兰州730000 [2]西安市长安区医院皮肤科,陕西西安710000

出　　处：《临床超声医学杂志》2025年第1期27-31,共5页Journal of Clinical Ultrasound in Medicine

基　　金：甘肃省科技厅青年科技基金项目(23JRRA0948)。

摘　　要：目的探讨高频超声联合剪切波弹性成像(SWE)评估寻常痤疮的临床价值。方法收集于我院就诊的寻常痤疮患者86例,按临床严重程度分级分为Ⅰ级组(20例)、Ⅱ级组(26例)、Ⅲ级组(20例)、Ⅳ级组(20例)。均行高频超声和SWE检查,比较各组痤疮的形态学特征(边界、形态、内部回声、后方回声、侵犯皮肤长度及深度等)、血流分级及弹性模量平均值;分析痤疮的超声图像特征与临床严重程度分级的相关性。结果Ⅰ级组痤疮均表现为边界不清晰、形态不规则、后方回声未见增强,60%(12/20)表现为毛囊增宽,40%(8/20)表现为真皮层内低回声区;Ⅱ级组痤疮均表现边界不清晰、形态不规则、后方回声未见增强、真皮层内低回声区,11%(3/26)可见点状钙化;Ⅲ级组痤疮均表现为边界不清晰、形态不规则、后方回声未见增强、真皮层内低回声区,30%(6/20)可见点状钙化;Ⅳ级组痤疮均表现边界清晰、形态规则、后方回声增强、真皮层及皮下组织低回声区,80%(16/20)可见点状钙化,20%(4/20)出现窦道。各组痤疮侵犯皮肤长度及深度比较差异均有统计学意义(均P<0.001);Ⅰ级组与Ⅱ级组、Ⅲ级组、Ⅳ级组血流分级比较差异均有统计学意义(均P<0.05),其余各组血流分级两两比较差异均无统计学意义;各组痤疮弹性模量平均值比较差异有统计学意义(P<0.05),且Ⅳ级组痤疮弹性模量平均值低于其余各组,差异均有统计学意义(均P<0.05)。相关性分析显示,痤疮内钙化、侵犯皮肤长度及深度、血流分级与临床严重程度分级均呈正相关(r=0.562、0.953、0.956、0.688,均P<0.001)。结论高频超声联合SWE可以评估不同临床严重程度分级的痤疮形态学特征、血流及硬度情况,有一定的临床价值。Objective To explore the clinical value of high-frequency ultrasound combined with shear wave elastography(SWE)in the evaluation of acne vulgaris.Methods A total of 86 patients with acne vulgaris in our hospital were collected,they were divided into 4 groups according to the clinical severity:Ⅰgroup(20 cases),Ⅱgroup(26 cases),Ⅲgroup(20 cases)andⅣgroup(20 cases).All groups underwent high-frequency ultrasound and SWE,the morphology features(boundary,morphology,internal echo,posterior echo,length and depth of skin invasion,etc.),blood flow grading and average elastic modulus value were compared.The correlation between the ultrasound image features of acne and the clinical severity grading were analyzed.Results Acne inⅠgroup presented with unclear boundaries,irregular shapes and no enhanced posterior echoes.60%(12/20)showed widened hair follicles,and 40%(8/20)showed hypoechoic areas in the dermis.Acne inⅡgroup presented with unclear boundaries,irregular shapes,no enhanced posterior echoes,and hypoechoic areas in the dermis.11%(3/26)showed punctate calcification.Acne inⅢgroup presented with unclear boundaries,irregular shapes,no enhanced posterior echoes,and hypoechoic areas in the dermis.30%(6/20)showed punctate calcification.Acne inⅣgroup presented with clear boundaries,regular shapes,enhanced posterior echoes,and hypoechoic areas in the dermis and subcutaneous tissue.80%(16/20)showed punctate calcification,and 20%(4/20)showed sinus tracts.There was significant difference in the length and depth of skin invasion among groups(both P<0.001).There were significant differences in blood flow grading between theⅠgroup andⅡgroup,Ⅲgroup,Ⅳgroup(all P<0.05),while there were no differences in blood flow grading among the other groups in pairwise comparsion.The difference in average elastic modulus values of acne among groups was statistically significant(P<0.05),and that ofⅣgroup showed lower average elastic modulus value than that of other groups(all P<0.05).Correlation analysis showed that there was

关 键 词：超声检查 剪切波弹性成像 寻常痤疮 

分 类 号：R445.1[医药卫生—影像医学与核医学]