手部肌腱断裂修复后腱性连接与疤痕连接的超声诊断  

Ultrasonographic Diagnosis of Tendinous and Non-tendinous Healing After Tenosuture of Hand Tendon Rupture

作　　者：张新[1] 孔军[1] 王明刚[1] 苏骅[2] 侯书健[2] 潘达德[2] 

机构地区：[1]解放军第401医院特检科,山东省青岛市266071 [2]全军手外科中心

出　　处：《中国超声医学杂志》2003年第1期43-45,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探索肌腱腱性连接与疤痕连接的超声影像学特征。方法 :应用高频超声探头动态观察手外伤患者肌腱修复后的愈合过程。结果 :术后形成肌腱腱性连接者 ,术后 1 0～ 2 0 d吻合部肌腱显示线样回声增强 ,其内可见少许细点状及斑点状强回声 ;术后 30 d吻合部肌腱回声略强于正常肌腱 ,其内可见少许细点状略强回声 ;术后 40 d吻合口肌腱回声近似正常 ,连续性好。术后形成肌腱疤痕连接者 ,术后 1 0～ 2 0 d吻合部肌腱线样回声连续性不清晰 ,回声较低与周围组织分界不清 ;术后 30 d吻合部肌腱出现条状及不规则状低回声 ,连续模糊 ;术后40 d吻合部肌腱回声出现小片状低回声部分内有细点状亮点 ,肌腱连续不清。结论 :超声检查吻合部可直观地观察肌腱断裂修复后的愈合过程 ,可以区分肌腱腱性连接与疤痕连接 。Objective: To find out the ultrasonographic characteristics of tendinous healing and non-tendinous healing after repair of hand tendon rupture.Methods:The healing process of 323 hand tendon ruptured cases were followed-up regularly by ultrasonographic examination Among this series of cases, 13 patients were healed by scar union, which were proved by secondary operation Ultrasonographic examination using high-frequency broadband linear-array transducer was performed at 10th?20th?30th and 40th postoperative days respectively.Results:In the tendinous healing cases, linear high echo area dotted with a few pinpoint and dotty high echoes were found on the repairing site at 10th and 20th days Nearly normal or normal echoes were found at 30th and 40th days respectively Continuity was good In the scar healing cases, linear echo signs with undefined continuity at 10th and 20th postoperative days were observed The intensity of echoes turned weak and demarcation with neighboring tissue was blurry.At 30th postoperative day, strip-like and irregular weak echoes with unobvious continuity were observed At the 40th postoperative day, tendon continuity was unclear Small patches of low echoes dotted with fine bright spots were observed at repairing site.Conclusions:Ultrasonographic examination can observe the healing process of repaired tendon directly and can distinguish tendinous healing from scar union, thus,can afford a reliable reason for the subsequent treatment.

关 键 词：手部 肌腱断裂 腱性连接 疤痕连接 超声诊断 修复术 

分 类 号：R445.1[医药卫生—影像医学与核医学]