颅脑枪弹伤的超声实验研究

目的 探讨颅脑枪弹伤致伤区的声像图特征及超声技术对其中组织活性判别的价值.方法 在制作穿透性颅脑枪弹伤模型的基础上,应用常规超声和超声造影技术观察致伤区组织声像图特征,并对比分析相应区域病理检查结果.结果 ①常规超声下致伤组动物颅内在沿伤道出人口之间可见一走行较平直、内径不一、边缘不整齐、易于分辨的管道状强回声.②超声造影示管道状强回声多完全无增强;也可部分无增强,部分区域呈较缓慢充盈的不均质低增强.③管道状强回声周围组织常呈现不均质低增强区和无增强区同时存在.④在上述充盈缺损和不均质低增强区外围可见一高增强区,于管道状同声短轴切面造影表现为一典型的环状高回声.结论 常规超声可简便有效地判定以管道状强回声为典型特征的颅脑枪弹伤致伤区分布及伤道走向,而超声造影技术则能准确显示枪弹伤致伤区失活组织,并可区分变性组织与正常组织.超声技术可促进颅脑火器伤救治水平的提高.

Ultrasound research on craniocerebral gunshot wound

Objective To explore the ultrasonographic characteristics in craniocerebral gunshot injured areas and the value of ultrasound technology for judging the activity of wound tissues. Methods After establishment of the model of penetrated craniocerebral gunshot wound, the ultrasonographic characteristics of the tissues in the injured areas were observed by conventional ultrasound and contrastenhanced ultrasonography(CEUS) ,and compared with the pathological changes of the wound area. Results ①A straight-looking, irregular-edged, easily distinguishable pipe-shaped high-level echo can be seen by conventional ultrasound in craniocerebral gunshot injured areas. ②The pipe-shaped strong echo usually shows non-enhancement by the CEUS,or shows homogeneous hypo-enhancement in some areas. ③Tissues around the pipe-shaped echo usually appears that the homogeneous hypo-enhancing area and non-enhancing area exist together. ④Around the above-mentioned the hypo-enhancing area and non-enhancing area, a hyper-enhancing area can be seen, and appears to be a typical ring-shaped high-level echo in short-axis section of the pipe-shaped echo. Conclusions Conventional ultrasound can easily shows the distribution of craniocerebral gunshot injured areas characterized by pipe-shaped high-level echo, and CEUS can precisely demonstrate necrotic tissues in the gunshot injured areas,distinguish them from the degenerative tissues and normal tissues. The application of ultrasound technology will greatly improve the therapeutic and treatmental level of the craniocerebral gunshot wound.