Propranolol Reduces Infantile Hemangioma Volume and Vessel Density
Propranolol Reduces Infantile Hemangioma Volume and Vessel Density
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DOI：
10.1177/0194599812451570
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发表时间：
2012-08-01
影响因子：
3.4
通讯作者：
Perkins, Jonathan A.
中科院分区：
文献类型：
--
作者：
Bingham, Matthew M.;Saltzman, Babette;Perkins, Jonathan A.
客观的。使用灰阶和彩色多普勒超声成像评估普萘洛尔治疗前后婴儿血管瘤组织的变化。研究设计。带有图表回顾的案例系列。设置。三级儿科医院。主题和方法。对质量改进数据库中确定的接受普萘洛尔治疗的头颈部婴儿血管瘤患者的医疗记录和图像研究进行了审查。纳入治疗前和治疗开始后至少 4 周进行过影像学检查的患者。收集的数据包括性别、年龄、地点和同时治疗。学生 t 检验用于评估皮肤病变面积、体积和血管密度的变化。使用逻辑回归来比较病变面积、体积和血管密度。结果。在确定的 177 名患者中，有 19 名符合纳入标准。 19 人中有 14 人是女性，19 人中有 5 人年龄超过 1 岁。治疗后的平均病变面积变化为 13.0 cm(2)（范围，-2.8 至 28.9 cm(2)，P = .05）。测得的体积变化平均值为 10.3 cm(3)（范围：1.5-19.2 cm(3)，P = .01）。平均血管密度变化为 4.4 个血管/cm(2)（范围，2.5-6.3 个血管/cm(2)，P < .01）。治疗使临床确定的血管瘤面积按比例减少，小于灰阶和彩色多普勒超声测量的病变体积。灰阶和彩色多普勒超声测量的治疗反应不随性别、病变部位或开始普萘洛尔时的年龄而变化。结论。普萘洛尔治疗的婴儿血管瘤的灰度和彩色多普勒超声成像检测到病变体积和血管密度显着减少。接受普萘洛尔治疗和同时使用皮质类固醇的患者年龄不影响病变体积变化。
Objective. To evaluate changes in infantile hemangioma tissue before and after propranolol therapy, using gray-scale and color Doppler ultrasound imaging.Study Design. Case series with chart review.Setting. Tertiary pediatric hospital.Subjects and Methods. Medical records and image studies of head and neck infantile hemangioma patients treated with propranolol, identified in a quality improvement database, were reviewed. Patients with imaging before and at least 4 weeks following the initiation of treatment were included. Data collected included sex, age, location, and concurrent treatment. Student t tests were used to evaluate change in cutaneous lesion area, volume, and vessel density. Logistic regression was used to compare lesion area, volume, and vessel density.Results. Of the 177 patients identified, 19 met inclusion criteria. Fourteen of 19 were female, and 5 of 19 were older than 1 year. Mean lesion area change with treatment was 13.0 cm(2) (range, -2.8 to 28.9 cm(2), P = .05). Measured volume change was a mean of 10.3 cm(3) (range, 1.5-19.2 cm(3), P = .01). Mean vessel density change was 4.4 vessels per cm(2) (range, 2.5-6.3 vessels per cm(2), P < .01). Treatment decreased clinically determined hemangioma area proportionately less than gray-scale and color Doppler ultrasound measured lesion volume. Gray-scale and color Doppler ultrasound measured treatment response did not differ with sex, lesion location, or age at propranolol initiation.Conclusion. Gray-scale and color Doppler ultrasound imaging of propranolol-treated infantile hemangiomas detected a significant reduction in lesion volume and vessel density. Patient age at propranolol treatment and concomitant corticosteroid use did not affect lesion volume change.