儿童肱骨远端骨骺生长发育的超声影像学特点  

Ultrasonic imaging characteristics of growth and development of distal humerus epiphysis in children

作　　者：刘方[1] 张思成[1] 华中托 马海龙 Liu Fang;Zhang Sicheng;Hua Zhongtuo;Ma Hailong(Department of Orthopedics,Anhui Provincial Children's Hospital,Anhui Medical University Children's Medical Center,Hefei230051,China)

机构地区：[1]安徽省儿童医院骨科安徽医科大学儿童医学中心,合肥230051

出　　处：《中华超声影像学杂志》2024年第11期941-946,共6页Chinese Journal of Ultrasonography

基　　金：安徽省卫生健康科研项目(AHWJ2022B008);安徽省自然科学基金项目(2208085QHQ241)。

摘　　要：目的探讨超声影像下不同年龄段儿童肱骨远端骨骺的标准影像学特点,为超声对肱骨远端骨骺损伤的诊断和治疗奠定基础。方法回顾性收集2022年1月至2023年12月在安徽省儿童医院骨科门诊、急诊就诊并自愿接受肱骨远端超声检查的3283例儿童的超声影像学资料,对所有病例相关流行病学资料进行描述性研究。采用超声从8个切面对肱骨远端进行扫查,分析不同年龄段的超声影像特点,并测量肱骨远端骺干角变化规律。结果纳入的3283例儿童在性别(男性、女性)比例、侧别(左、右)比例方面约为1∶1,汉族与其他民族比例约为24∶1。超声影像表现:肱骨远端的骨化中心随着年龄的增大而增大,首先出现的是肱骨小头骨化中心,其次是肱骨内上髁骨化中心,再次是肱骨滑车骨化中心,最后是外上髁二次骨化中心。随着年龄继续增长,肱骨远端外上髁、肱骨小头、肱骨滑车完全骨化与干骺端融合骨化成一个整体,但肱骨内上髁出现融合时间较晚。男性肱骨远端骺干角为(48.49±7.24)°,女性肱骨远端骺干角为(50.14±7.64)°,女性测值均略大于男性,但差异无统计学意义(P>0.05);肱骨小头前倾角度随年龄的增长而增大(P<0.001)。结论超声影像可以观察儿童肱骨远端骨骼的解剖特点,不同年龄阶段肱骨小头二次骨化中心大小和形态的变化以及肱骨远端骺干角等的变化,为肱骨远端骨骺损伤的诊断和治疗奠定了基础。Objective To investigate the standard imaging features of distal humerus epiphysis in children of different ages under ultrasound imaging,and to lay a foundation for the diagnosis and treatment of distal humerus epiphysis injury by ultrasound.Methods The ultrasound imaging data of 3283 children who voluntarily underwent distal humerus ultrasound at the Department of Orthopedics and Emergency of Anhui Children′s Hospital from January 2022 to December 2023 were retrospectively collected,and the relevant epidemiological data of all cases were described.The distal humerus was scanned by ultrasound from 8 dimensions to investigate the characteristics of ultrasonic images at different ages and to measure the changes of distal humerus epiphysis angle.Results The ratio of sex(male,female)and side(left,right)of all 3283 children included were about 1∶1,the ratio of Han nationality to other ethnic groups was about 24∶1.The ultrasonographic findings showed that the ossification center of the distal humerus increased with age.The ossification center of the small head of the humerus first appeared,followed by the ossification center of the internal epicondyle of the humerus,then the ossification center of the trochlear of the humerus appeared,and finally the secondary ossification center of the external epicondyle appeared.With age,the distal lateral epicondyle,capitulum and trochlea of the humerus became completely ossified and fused with the metaphyseal,but the fusion time of the internal epicondyle of the humerus was late.The distal humerus epiphysis angle in male was(48.49±7.24)°and(50.14±7.64)°in female.The measured value in female was slightly higher than in male,but there was no significant difference between the sexes(P>0.05).The anterior tilt angle of humerus small head increased with age(P<0.001).Conclusions Ultrasound imaging can observe the anatomical characteristics of the distal humerus bone in children,and can observe the changes of the size and shape of the secondary ossification center of the small

关 键 词：超声检查 儿童 肱骨 骨骺 骺干角 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.8[医药卫生—诊断学]