彩色多普勒超声及X线平片对异位骨化诊断的比较

目的比较彩色多普勒超声(彩超)及X线平片检查对脊髓损伤后异位骨化的早期诊断价值。方法对39例临床可疑异位骨化的脊髓损伤患者,在发生下肢水肿48h内进行首次彩超检查,每周复查,直至出现明确钙化灶。39例患者均同时进行X平片检查。结果脊髓损伤后异位骨化彩超所见:正常肌肉板层状结构肿胀增厚或被紊乱不规则结构取代,回声增强34例;出现弧形或长条形强回声带后伴声影39例;肌层内出现无回声血肿8例。外压性血管狭窄,流速增高4例。动态变化表现为:下肢水肿48h内,受累肌层肌纤维肿胀,回声增强,或病变中央区出现局限、形态不规则的非特异性低回声区;下肢水肿1周出现岛状回声增强区;1～2周后,出现大片弧形或长条形强回声带后伴声影,表面光滑或凹凸不平。下肢水肿1周内,彩超对异位骨化的检出率比X平片明显提高(P<0.01)。结论彩色多普勒超声可在患者起病初期检出阳性表现,是早期诊断异位骨化的可靠方法。

Early Diagnosis of Heterotopic Ossification after Spinal Cord Injury with Color Doppler Flow Imaging: Comparing with X-ray Photograph

Objective To investigate the role of color Doppler flow imaging(CDFI)in the early diagnosis of heterotopic ossification after spinal cord injury.Methods Serial CDFI and X-ray were performed per week in 39 patients with spinal cord injuries who were suspicioned with heterotopic ossification clinically.Results The finding under the CDFI including:losing of the regular lamellar pattern of the muscle fibres,chaotic irregular echogenic pattern,echo-free heamatoma,calcification,and extrinsic venous compression.There was statistical significance of incidence of diagnosis between CDFI and X-ray within a week(PP<0.01).Conclusion CDFI is effective on the early diagnosis of heterotopic ossification.