| Objective:Hemangiomas are benign tumors that develop due to rapid growth of the endothelial cells that line blood vessels.At present,there are many kinds of the treatments of hemangioma including laser treatment,injection hardening agent,radiation and radionuclide therapy,surgical treatment and oral administration of propranolol.Some hemangiomas can only be treated by oral administration of propranolol because they are not suitable for surgery,laser treatment,injection hardening agent and radiation and radionuclide therapy.The dose of the drug depends on the type,stage and progression rate of the tumor.Meanwhile,the curative effect was tested and the adverse reactions were reduced while the curative effect was improved.The research is to investigate the value of high resolution ultrasound,color doppler ultrasound and ultrasound elasticity imaging in the evaluation of infantile hemangiomas in patients treated with propranolol.Method:Fifty patients of special spot hemangioma diagnosed in Children's Hospital of Nanjing Medical University from January 2015 to January 2017 were collected.Age:28 days-12 months old;male 17,female 33.Fifty infants presented with 55 infantile hemangiomas located in different special organs treated with propranolol orally,were included in the study.Ultrasound examination was performed to measure the size of the lesion and the peak arterial systolic flow velocity(PASV)combing with the resistive index(RI),meanwhile the strain ratio of the lesion was also recorded before starting treatment,after 1 month,and 3 months of treatment duration,and at the end of treatment as well as up to 6 months after cessation of propranolol treatment.To compare whether there were differences in the monitoring indexes before and after treatment.In the control group,the carotid arteries were used in this study.Result:Among the 50 cases,37 cases were cured,12 cases were improved,and 1 case relapsed.Among the 50 children with hemangioma,9 cases were located in periorbital region,7 cases in parotid gland region,13 cases in nasolabial region,17 cases in facial region and 4 cases in mammary gland region?Evaluation of the efficacy of propranolol in the treatment of hemangioma by ultrasonography:(1)Hemangioma size of the transverse axis change(14.84±3.12mm)before medication,(5.88±2.04mm)6 month after taking medication;(2)Size of the longitudinal axis was(23.52±5.39mm)before medication,(9.92±3.12mm)6 month after taking medication;(3)Size of the tumor thickness was(11.76±2.34mm)before medication,(3.7± 1.52mm)6 month after taking medication;(4)The peak arterial systolic flow velocity(PASV)was(78.37±9.00 cm/s)before medication,(20.08±5.14 cm/s)6 month after taking medication;(5)The resistive index(RI)was(0.51±0.06)before medication,(0.73±0.04)6 month after taking medication;(6)The intralesional vessel thickness was(1.68±0.25mm)before medication,(0.6±0.13mm)6 month after taking medication;(7)The PASV of was(106.9±10.86 cm/s)before medication,(110.4±8.13 cm/s)6 month after taking medication;(8)The RI of was(0.741±0.028)before medication,(0.732±0.024)6 month after taking medication;(9)The vessel thickness was(3.69±0.42mm)before medication,(3.86±0.31mm)6 month after taking medication;(10)The pre-treatment elasticity score was 2.82±0.56,1.22±0.46 after 1 month of treatment,1.28±0.45 after3 months of treatment,2.96±0.57 after 6 month of treatment;(11)The pre-treatment elastic strain ratio was 3.15±0.62,1.71±0.41 after 1 month of treatment,1.73±0.39 after 3 months of treatment,2.99±0.50 after 6 month of treatment.The average decrease in size of the longitudinal axis was 58%;of the transverse axis,60%;tumor thickness,69%;and intralesional vessel thickness,64%.The PASV and RI of the intralesional vessel were decreased an average of 74%and increased an average of 43%.The rate of 1 month after taking medication compared with pre-treatment,3 months after taking medication compared with 1 month after treatment,6 months after taking medication compared with 3 month after treatment,there was a significant difference between the groups(P<0.05).The elastic strain ratio were decreased an average of 46%after treatment by propranolo 3 months later,therewas no significant difference between the two groups,before treatment compared with 6 month after treatment(P>0.05),1 month after treatment compared with 3 months after treatment(P>0.05).There was no significant difference among the pre-treatment and after taking medication in the data of the peripheral vessels(P>0.05).Conclusion:Collectively,high efficacy and tolerance of propranolol treatment have been elicited.The size and the PASV of the hemangioma were significantly decreased after treatment,while RI was significantly increased,but the elasticity index did not change by ultrasonography.However,peripheral vascularity was not significantly affected.Ultrasound examination permits noninvasive quantification of the changes in IHs and peripheral vessels in patients receiving propranolol therapy.It is worthy of clinical popularization and Application. |
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