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

Dan Lv,1,* Xi Yang,1,* Xin Mao,1,* Mei Zhang,1,* Xuemeihui Ma,1 Yuanyuan Liu,1 Guangsen Li,1 Bingbing Yang2 1Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116027, People’s Republic of China; 2Department of Cardiovascular Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116027, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bingbing Yang, Email [email protected] Guangsen Li, Email [email protected]: 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 C2 (n=33), group C3 (n=35), group C4a (n=24), and group C4b (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 C2 groups, the C3, C4a, and C4b 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 C3, group C4a to group C4b (all P< 0.05). Compared to the control, C2, and C3 groups, both the C4a and C4b 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 C4b showing higher values than group C4a (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.Keywords: shear wave elastography, skin elasticity, chronic venous disease