A Retrospective Study of the Efficacy of Different Treatment on Capillary Vascular Malformation: Evaluation of Using Digital Image Analysis
Date Issued
2006
Date
2006
Author(s)
Lee, Jian-Jr
DOI
en-US
Abstract
Background:
Port-wine stains (PWS) are capillary forms of vascular malformation. They are usually found at birth, persist throughout the whole life, and progress to hypertrophic stage, and sometimes complicate with nodular change. The patients with port-wine stains may usually suffer from psychological disabilities and social withdraw.
Clinically, the physicians used to treat simple PWS with dye laser, but they can not get a long term good result for mature PWS because of limited penetration of laser. It may take dozen times to treat PWS, and may fail eventually.
Sodium tetradecyl sulfate (STS) is a kind of sclerosing agent, which belongs to a salt of long chain fatty acid, like soap, and works on the endothelial cells of vessels and damages the intima, and then leads to vascular thrombosis and subsequent fibrosis. The physicians use it for treating vascular lesions, such as vascular malformation and varicose vein.
In this study, we treat the PWS lesions with sclerosing agent injection first for several times, and then combine with dye laser treatment to get better results.
We utilize the technique of digital image processing to establish the objective assessments for clinical results, and discuss with statistical methods.
Materials and methods:
267 patients are collected from two medical centers (National Taiwan University Hospital and Cathay General Hospital) at Taipei, from December 1986 to April 2006. All data are analyzed retrospectively. 126 cases remain in the study after we exclude the cases that their following time are less than 6 months and those combined with other vascular deformities.
They are assigned into four treatment groups: non-treatment, laser treatment only, sclerotherapy only, and combination of laser and sclerosing agent treatment group. These patients are also grouped by disease progression, as juvenile stage, hypertrophic stage, and nodular change. The pathophysiologic status of the PWS is also taken into consideration, and is divided as warm type, intermediate type, and cold type.
After treatment, pre and post therapy images are assessed with computer software under the HSI (hue, saturation, intensity) color image model. The differential ratio of the lesion to the normal skin by the change of saturation and intensity during treatment is defined as PWS index, which is comparable on the same patient, and then discussed with statistical methods.
Results:
There are significant changes after combination treatment, but not so by other treatment. The juvenile stage patients have the better results than hypertrophic stage patients in all treatment groups. But if we treat the hypertrophic stage PWS patients with combination method, they could still get a significant improvement after treatment.
The intermediate type PWS patients have the better results than warm and cold type patients. It means the warm and cold type PWS may have relatively poor outcome.
Subjects
血管瘤
血管畸形
血管紅色母斑
硬化劑
染料雷射
數位影像
色彩模型
Port wine stains
vascular malformations
sclerotherapy
sclerosing agent
dye laser
digital image processing
color model
Type
text