The study of Sonography of hyperplastic scar at different stages with 20 MHz high-frequency ultrasound
Objective To provide reference and guidance for the objective assessment and diagnosis of hypertrophic scar staging using 20 MHz high-frequency ultrasound by observing the differences in sonographic characteristics,scar thickness,and echo intensity of hypertrophic scar skin at different stages.Methods A to-tal of 65 patients with hypertrophic scars admitted to the Plastic Surgery and Burn Department of the Affilia-ted Hospital of Southwest Medical University from September 2019 to June 2023 were enrolled and divided in-to an early stage group(＜3 months,n=20),a proliferative stage group(3-＜6 months,n=15),a remode-ling stage group(6-＜12 months,n=15),and a mature stage group(≥12 months,n=15)based on the stage of their hypertrophic scars.Additionally,20 normal skin volunteers from Sichuan,Yunnan,Guizhou,and Chongqing were randomly selected as the normal skin group.20 MHz high-frequency ultrasound was used to acquire images of scars and normal skin,and the full-thickness of the skin and echo intensity of the upper and lower dermis were measured.Hematoxylin and eosin staining was also performed to observe the pathological structure of scar tissue under a light microscope.Results The epidermis was relatively smooth in both the early and mature stage groups.In the early stage group,the boundaries between the skin sublayers were rela-tively clear,with an increased number of microvessels,while in the mature stage group,the boundaries were unclear,arranged in disorder,and the number of microvessels was reduced.In both the proliferative and re-modeling stage groups,the epidermis was uneven and uplifted,with intact dermal and subcutaneous tissue structures and clear boundaries.The collagen fibers in the dermis were coarse and arranged in disorder.The full-thickness of the skin in the proliferative and remodeling stage groups was significantly thicker than that in the early,mature stage,and normal skin groups,with statistically significant differences(P＜0.05).There was no statistically significant difference in thickness between the early stage group and the normal skin group(P＞0.05).The echo intensity of both the upper and lower dermis decreased in the early and proliferative stage groups,while it increased in the upper dermis in the remodeling and mature stage groups.The hypoecho-ic area in the lower dermis persisted until the remodeling stage and then increased from the remodeling to the mature stage.There was no statistically significant difference in dermal echo intensity between the mature stage group and the normal skin group(P＞0.05).The dermal echo intensity of the normal skin was relative-ly uniform,while that of the mature stage group was heterogeneous.Conclusion 20 MHz high-frequency ul-trasound demonstrates characteristic sonographic features of hypertrophic scars at different stages,reflecting the clinical manifestations and structural changes of hypertrophic scars at different stages.It has important clinical significance for the objective assessment and diagnosis of hypertrophic scar staging.
万方数据
维普
