High frequency ultrasound assessment of skin fibrosis: Clinical results
High frequency ultrasound assessment of skin fibrosis: Clinical results
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DOI：
10.1016/j.ultrasmedbio.2007.02.009
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发表时间：
2007-08-01
影响因子：
2.9
通讯作者：
Choi, A. P. C.
中科院分区：
文献类型：
--
作者：
Huang, Y. P.;Zheng, Y. P.;Choi, A. P. C.
纤维化是癌症患者放射治疗的常见晚期效应。目前放射性纤维化的临床评估通常限于基于临床医师的评定量表，这通常不足以进行定量和客观的评价。组织的超声传播特性被广泛报道为对组织成分和结构的改变敏感。基于我们之前的可行性研究，我们使用了包括皮肤厚度在内的四个参数和真皮组织的三个超声参数（衰减斜率[β]、积分衰减[IA]和积分背向散射[IBS]），在10至25 MHz的频率范围内评估皮肤纤维化。实验在颈部放射后纤维化患者的前臂和颈部皮肤上进行。还测量了颈部软组织的触诊评分和硬度，作为纤维化严重程度的指标。比较38名患者和20名对照受试者的结果显示，患者颈部皮肤的β值显著较小（p = 0.005），皮肤厚度显著较大（p < 0.004），IA（p = 0.04）。然而，年龄匹配的比较显示，使用手动触诊评估的不同纤维化程度的患者亚组之间没有显著差异，四个参数与颈部软组织的总体硬度之间也没有显著相关性（p > 0.05）。总之，超声组织定征可以为颈部区域辐射后皮肤纤维化的评估提供额外的信息。进一步的研究是必要的，以探讨应用目前的测量区分皮肤纤维化的严重程度的可行性。
Fibrosis is a common late effect of radiotherapy treatment for cancer patients. Current clinical assessment of radiation-induced fibrosis is generally limited to clinician-based rating scales, which are usually not sufficient for quantitative and objective evaluations. Ultrasonic propagation properties of tissues are widely reported to be sensitive to the alterations of tissue compositions and structures. Based on our previous feasibility study, we used four parameters including skin thickness and three ultrasonic parameters of dermal tissues (attenuation slope [beta], integrated attenuation [IA] and integrated backscatter [IBS]) in the frequency range of 10 to 25 MHz for the assessment of skin fibrosis. Experiments were conducted on the forearm and neck skin in patients with postirradiation fibrosis in the neck region. The palpation score and stiffness of the neck soft tissue were also measured as an indication of fibrotic severity. Comparisons of the results between 38 patients and 20 control subjects showed a significantly smaller beta (p = 0.005) and a significantly larger skin thickness (p < 0.004) and IA (p = 0.04) in the neck skins of the patients. However, age-matched comparisons showed there were neither significant differences among patient subgroups with different fibrotic levels assessed using manual palpation or significant correlations between the four parameters and the overall stiffness of the neck soft tissues (p > 0.05). In conclusion, ultrasound tissue characterization may provide additional information for the assessment of postirradiation skin fibrosis in the neck region. Further studies are necessary to investigate the feasibility of applying the current measurement for differentiating the severity of skin fibrosis.