A Novel, Reliable Protocol to Objectively Assess Scar Stiffness Using Shear Wave Elastography

• Published in: Ultrasound in medicine & biology Vol. 46; no. 7; pp. 1614 - 1629
• Main Authors: DeJong, Helen, Abbott, Steven, Zelesco, Marilyn, Spilsbury, Katrina, Martin, Lisa, Sanderson, Rowan, Ziman, Melanie, Kennedy, Brendan F., Wood, Fiona M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-07-2020
• Subjects: 2-D shear wave elastography; Burn; Elastography; Objective scar assessment; Reliability; Scar pliability; Shear wave elastography; Burn; Scar pliability; Shear wave elastography; Objective scar assessment; 2-D shear wave elastography; Reliability; Elastography
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2020.03.003

The aim of this research was to investigate the use of shear wave elastography as a novel tool to quantify and visualize scar stiffness after a burn. Increased scar stiffness is indicative of pathologic scarring which is associated with persistent pain, chronic itch and restricted range of movement. Fifty-five participants with a total of 96 scars and 69 contralateral normal skin sites were evaluated. A unique protocol was developed to enable imaging of the raised and uneven burn scars. Intra-rater and inter-rater reliability was excellent (intra-class correlation coefficient >0.97), and test–retest reliability was good (intra-class correlation coefficient >0.85). Shear wave elastography was able to differentiate between normal skin, pathologic scars and non-pathologic scars, with preliminary cutoff values identified. Significant correlations were found between shear wave velocity and subjective clinical scar assessment (r = 0.66). Shear wave elastography was able to provide unique information associated with pathologic scarring and shows promise as a clinical assessment and research tool.