高频超声在带状疱疹诊断中的应用

目的应用高频超声观察各期带状疱疹患者的皮肤和皮神经的声像图改变，为临床早期诊断寻求影像学依据。方法75例拟诊断为带状疱疹患者，其中男性31例，女性44例，年龄22～79岁。病变位于躯干54例，四肢近端21例。采用直接扫查法，用10MHz彩色多普勒超声检测患者病变处皮肤层及皮下组织层厚度、皮神经直径和各层回声情况，以患者健侧对应部位为对照。结果67例确诊为带状疱疹，高频超声显示出疹前期及红斑丘疹期患者病变处与健侧比较皮肤层及皮下组织层明显增厚（P＜0．01），皮神经直径明显增大（P＜0．01），回声均减低；水疱期患者病变处皮肤层及皮下组织层未见明显增厚（P＞0．1），回声未见明显减低；但皮神经直径仍可见增大（P＜0．01），回声减低。结论高频超声检测带状疱疹患者（特别对早期不典型患者）皮肤和皮神经声像图表现异常，为临床早期诊断、减少误诊提供了影像学依据。

Application of high-frequency ultrasonography in diagnosis of herpes zoster

Objective To study the sonographic changes of skin and cutaneous nerves in patients of herpes zoster with high-frequency ultrasonography. Methods In sixty-seven patients of herpes zoster color Doppler ultrasonography were performing to examine with thickness and echo feature of the dermal and subcutaneous tissue as well as diameter and echo feature of the cutaneous nerves. The above results were compared with the contralateral uninjured side of the same patient. Results Compared with the uninjured side,at the stage of preeruption and erythema or exanthema,the thickness of skin or subcutaneous tissue was increased (P < 0.01),the diameters of the cutaneous nerves were also increased (P < 0.01),and the echoes were significantly decreased; at the stage of populovesicle,the thickness of the skin or subcutaneous tissue was increased unmarkedly (P > 0.1),the echo was not decreased,but the diameters of the cutaneous nerves were increased (P < 0.01),and the echoes were decreased,too. Conclusion High-frequency ultrasound can detect abnormal sonographic appearances in the skin,subcutaneous tissue or cutaneous nerves of patients with early stage herpes zoster. Thus this approach could provide imaging evidence for early clinical diagnosis and reduce misdiagnosis.