Assessing Treatment Efficacy in Alopecia Areata: A Combined High-Frequency Ultrasound and Superb Microvascular Imaging Study

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2026-10-13 Epub Date: 2026-08-22 DOI:10.1002/jum.70299

Meng Yang MM, Chen Zhao MD, Jia Chen MD, Xin Ai MM, Shouqiang Li MD, Zhuo Wang MD, Zhinuo Li MM, Zhirou Di MM, Bingxue Bai PhD, Xiaoping Leng PhD

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引用次数: 0

Abstract

Objectives

The therapeutic goals for alopecia areata (AA) are to suppress local immune inflammation, restore hair follicle structure, and improve surrounding blood perfusion. However, current efficacy evaluations largely rely on subjective clinical observation and lack objective quantitative methods. High-frequency ultrasound (HFUS) can clearly display the location and morphology of hair follicles. Combined with microvascular assessment techniques, it enables quantitative detection of low-velocity blood flow and related parameters, providing an objective basis for evaluating AA treatment efficacy.

Methods

Forty-five patients with AA who received intralesional therapy underwent HFUS (measuring epidermal/dermal thickness and hair follicle length/width) and ultrasound microvascular assessment, including spectral Doppler measurement of peak systolic velocity (PSV), resistance index (RI), and power Doppler measurement of vascular index (VI) before and after treatment. Patients were divided into a responder group (n = 37) and an ineffective group (n = 8) based on the reduction rate of the SALT score. The Mann–Whitney U test and Wilcoxon signed-rank test were used for comparisons between groups and within the responder group (pre-treatment versus post-treatment), respectively.

Results

Baseline characteristics showed no statistically significant differences (all p > .05). Patients in the ineffective group exhibited poorer hair follicle morphology (shorter length, greater width, and lower length-to-width ratio), but higher PSV and VI compared to the responder group (p < .05). In the responder group, treatment significantly improved hair follicle morphology, increased PSV and VI (p < .05), but RI showed no change.

Conclusions

(1) HFUS technology can observe changes in AA hair follicle structure during the diagnosis and treatment process, evaluating the effectiveness of treatment regimens in improving AA disease progression. (2) SMI combined with Doppler flow parameters can monitor changes in the perifollicular microcirculation in AA, reflecting the improvement of microcirculation during the diagnosis and treatment of AA. (3) The synergistic application of HFUS and SMI technologies can provide an objective imaging basis for the clinical evaluation of AA treatment efficacy, demonstrating promising clinical application prospects.

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评估斑秃的治疗效果：高频超声和高超微血管成像的联合研究。

目的：对斑秃（AA）的治疗目的是抑制局部免疫炎症，恢复毛囊结构，改善周围血液灌注。然而，目前的疗效评价主要依靠主观的临床观察，缺乏客观的定量方法。高频超声（HFUS）可以清晰显示毛囊的位置和形态。结合微血管评估技术，可定量检测低速血流及相关参数，为评价AA治疗效果提供客观依据。方法：45例接受病灶内治疗的AA患者行HFUS（测量表皮/真皮厚度、毛囊长/宽）及超声微血管评估，包括治疗前后收缩压峰值速度（PSV）、阻力指数（RI）、血管指数（VI）的功率多普勒测量。根据SALT评分降低率将患者分为缓解组（n = 37）和无效组（n = 8）。Mann-Whitney U检验和Wilcoxon符号秩检验分别用于组间和反应组内（治疗前与治疗后）的比较。结果：基线特征差异无统计学意义（p < 0.05）。无效组患者毛囊形态较有效组差（长度较短、宽度较大、长宽比较低），但PSV和VI较有效组高(p)。结论：(1)HFUS技术可观察AA诊断和治疗过程中毛囊结构的变化，评价治疗方案对改善AA疾病进展的有效性。(2) SMI联合多普勒血流参数可监测AA患者滤泡周围微循环的变化，反映AA诊断和治疗过程中微循环的改善。(3) HFUS与SMI技术协同应用可为临床评价AA治疗效果提供客观的影像学依据，具有良好的临床应用前景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound