Shear Wave Elastography to Quantitatively Assess the Early Changes of Skin Elasticity in Patients with Chronic Venous Disease of the Lower Extremity

剪切波弹性成像定量评估下肢慢性静脉疾病患者皮肤弹性的早期变化

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Abstract

OBJECTIVE: To explore the value of shear wave elastography (SWE) in quantitatively evaluating skin elasticity during early changes in patients with chronic venous disease (CVD) of the lower extremity. METHODS: This retrospective study analyzed 112 patients with CVD of the lower extremity, who were enrolled and divided into four groups according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification criteria, including group C(2) (n=33), group C(3) (n=35), group C(4a) (n=24), and group C(4b) (n=20). Additionally, 30 healthy individuals were recruited as the control group. Differences in baseline clinical characteristics, laboratory parameters, conventional ultrasound parameters and SWE parameters among the five groups were compared. Correlations between SWE parameters of the dermal and subcutaneous tissue layers and laboratory parameters were analyzed. RESULTS: Compared with the control and C(2) groups, the C(3), C(4a), and C(4b) groups exhibited significantly higher levels of C-reactive protein (CRP), matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), subcutaneous tissue thickness (SCTT), maximum Young's modulus of subcutaneous tissue (SCT-Emax), mean Young's modulus of subcutaneous tissue (SCT-Emean), and minimum Young's modulus of subcutaneous tissue (SCT-Emin) (all P<0.05). Furthermore, these indices progressively increased from group C(3), group C(4a) to group C(4b) (all P<0.05). Compared to the control, C(2), and C(3) groups, both the C(4a) and C(4b) groups demonstrated greater dermal thickness (DT), maximum Young's modulus of dermal layer (D-Emax), mean Young's modulus of dermal layer (D-Emean), and minimum Young's modulus of dermal layer (D-Emin) (all P<0.05), with group C(4b) showing higher values than group C(4a) (all P<0.05). Correlation analysis revealed that SWE parameters of the dermal and subcutaneous tissue layers were significantly correlated with MMP-2 and IL-6, respectively. CONCLUSION: SWE enables quantitative assessment of skin elasticity during the early changes in patients with CVD of the lower extremity.

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