| Objective(s):Infantile hemangioma(IH)are the most common benign vascular tumors in infants.Oral propranolol is the first-line drug for clinical treatment of IH.Because of the facial IH is high risk,standardized treatment and accurate evaluation of efficacy are very important to improve the outcomeof children.Our research aim to observe the facial IH in infants treated with propranolol by High frequency ultrasound and Spectral Doppler Ultrasound.To explore the application value of high-frequency ultrasound in the diagnosis and predictive efficacy evaluation of infantile facial hemangioma.Methods: The subjects of this study were children with moderate-risk and high-risk infantile facial hemangiomas clinically diagnosed in Kunming Children Hospital from January 2020 to January 2021.According to the age of the children,theywere divided into four groups : 1-3 months,4-6 months,7-9months and 10-12 months.Before treatment,the first color Doppler highfrequency ultrasound examination was performed to measure the size of IH lesions and calculate the volume of lesions.The morphological boundary characteristics,internal echo type and blood flow information in the lesion were observed,and the peak systolic velocity(PSV),resistance index(RI)and(or)Venous flow rate(Vmax)were measured.IH were divided into superficial type,deep type and mixed type according to the skin layer and depth of the lesion,and the sonographic features of each type of IHs were observed.According to the characteristics of IHs lesion boundary,it is divided into “vertical boundary”type and “slope boundary”type.Results: A total of 169 children with IH with complete data were collected in this study,all of which were single,including 116 female children(68.6 %).The age of first diagnosis was 1-3 months in 85 cases(50.3 %),4-6 months in 41 cases(24.3 %),7-9 months in 22 cases(13.0 %),10-12 months in 21 cases(12.4 %).Children aged 4-9 months with larger IHs lesions.The lesions had mixed echo(75.1 %)and rich blood supply(97.6 %).The types of IHs lesions included superficial type(11.2 %),deep type(13.0 %)and mixed type(75.8 %).The boundary features included 73 cases of “vertical boundary ”and 96 cases of “slope boundary”.After 6 months of oral propranolol treatment,169 cases of lesions were evaluated as 153 cases(90.5 %)in the effective group,including 109 cases(64.5 %)with obvious regression and 44 cases(26.0 %)with basic control.The effective rates of IH with 7-9 months old,superficial and sloping growth were 100.0%,100.0% and94.8 % respectively,which showed that the volume of lesions decreased after treatment,the color blood flow classification,the peak systolic velocity(PSV)and venous velocity(Vmax)of the large penetrating artery in the lesions decreased,and the resistance index(RI)increased,with statistically significant differences(P <0.05).The ROC curve showed that the parameters of IH lesion volume,anteroposterior diameter,left and right diameter,upper and lower diameter,arterial PSV and RI,and venous Vmax had certain predictive efficacy for the therapeutic effect of IHs in children.The area under the curve(AUC)of volume was the largest,which was 0.865,and the sensitivity and specificity were 92.00 % and 81.00 %,respectively,with the higher predictive efficacy.Conclusion(s): High frequency ultrasound can assist the clinical classification of IH and distinguish the edge characteristics of IH lesions.In the effective group of propranolol treatment,superficial IH and slope edge IH accounted for more.The volume of lesions measured by high-frequency ultrasound decreased most significantly in children with IH aged 4-9 months after propranolol treatment.The IH lesion volume,anteroposterior diameter and RI measured by high-frequency ultrasound were the most sensitive to predict the efficacy of propranolol IH. |
PDF Full Text Request