高频超声对诊断婴幼儿早期佝偻病的价值  

Preliminary studies on premature rickets of infants by high-frequency probe ultrasound

作　　者：于明安 许祖闪[2] 汤钟娟 宋晶 刘杰[2] 李强 宫华芳 毕海静 

机构地区：[1]山东省威海市妇女儿童医院超声科,264200 [2]威海市文登中心医院放射科 [3]山东省威海市妇女儿童医院小儿科,264200

出　　处：《中华放射学杂志》2002年第3期249-253,共5页Chinese Journal of Radiology

摘　　要：目的　研究婴幼儿早期佝偻病的声像图特征 ,评估高频超声对婴幼儿早期佝偻病的诊断价值。方法　选取经临床检查确诊为佝偻病的婴幼儿 12 3例 (诊断标准采用 1999年全国佝偻病防治科研协作组修订标准 ) ,同时选取 30例经临床诊断为正常的婴幼儿作为对照组。采用高频探头检查右侧尺、桡骨远端及右侧第 4前肋干骺端。结果　高频探头可清晰显示尺、桡骨远端及肋骨干骺端各部位的改变。与正常对照组比较 ,在骨膜与软骨膜衔接处分别可见断裂、骨皮延伸及骨皮翘起等征像。骨皮延伸的发生率在尺骨为 18 7% (2 3例 ) ,在桡骨为 10 6 % (13例 ) ,在肋骨为 41 5 % (5 1例 ) ;骨皮翘起的发生率在尺骨为 4 9% (6例 ) ,在桡骨为 2 4% (3例 ) ,在肋骨为 18 7% (2 3例 )。χ2 检验结果示 ,骨皮延伸和骨皮翘起在肋骨的发生率明显高于尺、桡骨 (P值均 <0 0 1)。临时钙化带边缘钙化不全者 ,尺骨 119例 (96 75 % ) ,桡骨 84例 (6 8 2 9% ) ;临时钙化带内部钙化不全者 ,桡骨 74例 (6 0 16 % ) ,尺骨 5 2例 (42 2 8% ) ;发生率经Ridit分析 ,差异均具有非常显著性意义 (P值均 <0 .0 1)。结论　高频超声可显示婴幼儿早期佝偻病的各种征像 ,有助于评估婴幼儿缺钙的状态及程度。Objective To observe the ultrasound appearance of premature rickets in infants, and to assess the diagnostic value of high frequency probe in the disease. Methods Ultrasonography was performed in R No 4 rib and distal radioulnar metaphysis in 123 rickets infants diagnosed by clinical examination (the diagnosis standard adopted the rickets diagnose standard revised by the rickets research,prevention and cure group of China in 1999) and in 30 normal infants diagnosed by clinical examination as the control group. Results The high frequency probe could clearly visualize the modification of every part in ribs and distal radioulnar metaphysis. Compared with that of the normal control group, ultrasound showed individually the signs and symptoms such as separation, bone bark elongation, and bone bark warp in the engagement of periosteum and perichondrium in rickets group. The incidences of bone bark elongation were separately 18.7% (23 cases) in ulna, 10.6% (13 cases) in radius, and 41.5% (51 cases) in rib; The incidences of bone bark warp were separately 4.9% (6 cases) in ulna, 2.4% (3 cases) in radius, and 18.7% (23 cases) in rib. The results of chi square test showed thatboth the incidences of bone bark elongation and bone bark warp between the rib and the ulna and radius had significant difference ( P <0.01). The incidences of incomplete calcification in the edge of the provisional calcification zone were 96.75% (119 cases) in ulna and 68.29% (84 cases) in radius, respectively (Ridit test, P <0.01). The incidences of incomplete calcification inside the provisional calcification zone were 42.28% (52 cases) in ulna and 60.16% (74 cases) in radius, respectively (Radit test, P <0.01). Conclusion Study on every modification of premature rickets by high frequency probe will help to determine the status and degree of calciprivia at earlier stages, and thereby to increase the specificity and sensitivity of ultrasonography.

关 键 词：佝偻病 超声检查 尺骨 桡骨 肋骨 诊断 婴幼儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]