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Correlation between elastic modulus and clinical severity of pathological scars: a cross-sectional study
Jing Hang1, Jie Chen2, Weixin Zhang1
1Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Scientific Reports
|December 3, 2021
Summary
The modified Vancouver Scar Scale (mVSS) for pathological scars has limitations. Shear wave elastography (SWE) measures scar stiffness, correlating with mVSS within specific thresholds, but differs between hypertrophic scars and keloids.
Area of Science:
- Biomedical Engineering
- Dermatology
- Medical Imaging
Background:
- The modified Vancouver Scar Scale (mVSS) is a common but subjective tool for assessing pathological scars.
- Shear wave elastography (SWE) offers an objective method to measure tissue stiffness, showing promise for scar evaluation.
Purpose of the Study:
- To investigate the correlation between the modified Vancouver Scar Scale (mVSS) and elastic modulus (EM) measured by shear wave elastography (SWE) in pathological scars.
- To explore potential threshold effects and differences in this correlation between hypertrophic scars and keloids.
Main Methods:
- Sixty-nine pathological scars (28 hypertrophic, 41 keloids) were assessed using mVSS and SWE.
- Elastic modulus (EM) was measured by SWE, including average scar stiffness (EMWHOLE) and stiffness of the hardest scar area (EMHARDEST).
- Univariable, multivariable, and threshold effect analyses were performed to determine the relationship between mVSS and EM.
Main Results:
- Univariable analysis showed a correlation between EM and mVSS, but linear multivariable analysis did not.
- A positive correlation between EM and mVSS was observed when EMWHOLE was <166.6 kPa or EMHARDEST was <133.07 kPa.
- Keloids showed a linear association between mVSS and EMHARDEST, while hypertrophic scars exhibited a nonlinear, threshold-dependent association.
Conclusions:
- Elastic modulus measured by SWE correlates with mVSS in pathological scars, but this relationship is dependent on stiffness thresholds.
- The association patterns between scar stiffness and clinical assessment differ significantly between hypertrophic scars and keloids.
- SWE shows potential as an objective tool to complement subjective scar assessment scales like mVSS.
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