猪肢体枪弹伤失活组织区域超声造影显像的实验研究  

Ultrasonic contrast imaging of devitalized tissue area of bullet wounds to pig extremities：an experimental study

作　　者：李茜[1] 邓旦[1] 陈重[1] 吴晓波[1] 陶杰[1] 赵恒[1] 

机构地区：[1]成都军区总医院超声科,610083

出　　处：《中华超声影像学杂志》2014年第10期907-910,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨超声造影技术对猪肢体枪弹伤失活组织区域判定的价值.方法 利用53式滑膛枪建立猪肢体软组织枪击伤模型,应用常规超声及超声造影技术观测猪伤肢原发伤道及其周围软组织声像图表现,并与病理结果对比分析.结果 常规超声显像猪肢体枪击伤原发伤道呈走行较清晰的管道状回声,伤道内部回声可随时间延长而发生变化.致伤区超声造影后除原发伤道显示为充盈缺损区外,紧邻伤道周围的部分组织也可呈充盈缺损表现,病理显示充盈缺损区均为失活坏死组织,而造影后伤道周围组织的不均质低增强表现以及最外围的环状高增强表现病理提示分别为以变性组织改变为主和小血管扩张充血改变为主.结论 常规超声可判断猪肢体枪弹伤致伤区原发伤道的走行,而超声造影技术则可以精细识别致伤区域失活组织,两者联合应用有助于促进枪弹伤救治水平的提高.Objective To explore the value of the determination of the devitalized tissue area of bullet wounds in the pig extremities by contrast-enhanced ultrasound（CEUS）.Methods A model of bullet wounds to the pig limb soft tissue was constructed with a model 53 smoothbore.The sonographic features of the soft tissue of and around the primary traumatic channel of the pig extremities were observed by routine ultrasound and CEUS and compared with the pathological findings.Results The primary traumatic channel of bullet wounds to the pig extremities produced clearer tubular echoes under routine ultrasonic imaging.The echoes from inside the traumatic channel changed with time.Part of tissue close to the periphery of the traumatic channel presented with a filling defect area except the primary traumatic channel after ultrasonic contrast of the traumatogenic area.The pathological examination revealed devitalized necrotic tissues in the filling defect area while the heterogeneous low potentiation of the tissue around and the most peripheral circular high potentiation of the traumatic channel indicated a degenerative tissue change and a small angiectatic change after CEUS.Conclusions Routine ultrasound may determine the run of the primary traumatic channel in the traumatogenic area of bullet wounds to the pig extremities while CEUS may accurately distinguish the devitalized tissue in the traumtogenic area.The combination of both is bound to raise greatly the level of the treatment and cure of bullet wounds.

关 键 词：超声检查 微气泡 四肢 枪弹伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]