超声检查在膝关节创伤性积脂血症中的应用价值

目的 通过体外实验及临床研究,探讨超声检查在膝关节创伤性积脂血症中的脂肪层厚度下限及应用价值. 方法 实验组:对20支内含新鲜血液与猪骨髓混合液体的试管充分摇匀,静置10 min行超声检查.临床组:对2007年1月至12月收治的40例膝关节积脂血症患者在术前进行超声、X线片、CT及MRI检查,男28例,女12例;平均年龄42.9岁.观察实验组标本和临床组患者的脂肪层厚度. 结果 实验组:脂肪层从稀薄不成层至厚度14.0 mm,层厚达0.5 mm(脂肪量0.07mL)以上者均可清晰显示.临床组:超声检查40例均清晰显示膝关节积脂血症,脂肪层厚度为0.6～12.0 mm,其中有6例厚度小于3.0 mm,在各部位显示的脂肪层厚度与CT、MRI结果相吻合;12例显示骨折线影;6例隐匿性骨折患者是经关节积脂血症而确诊的.X线片示33例为关节积脂血症,34例显示骨折线.40例CT和MRI均显示关节积脂血症和骨折线. 结论 超声检查对创伤性关节积脂血症的脂肪层非常敏感,检测下限为0.5 mm.超声检查是检测关节积脂血症的较好影像方法之一.

The lower limit of ultrasonography detection in traumatic joint lipohemarthrosis

Objective To determine the lower limit of fat layer thickness the ultrasonography can detect in traumatic joint lipohemarthrosis and its clinic application. Methods In the experimental group, 20 samples, composed of fresh blood and pig marrow, were fully agitated and examined by ultrasonography after standing for 10 minutes. In the clinical group, 40 knees with lipohemarthrosis were examined by ultrasonography, X-ray, CT and MR before operation from January 2007 to December 2007. Results In the experimental group, the fat layer thickness ranged from none to 14 mm. The former showed spot medium echo,floating on the top of serum, not clearly. The fat layer thickness beyond 0. 5 mm (fat mass 0.07 mL) was shown clearly, with medium echo. In the clinical group, ultrasonography showed lipohemarthrosis clearly in all the 40 knees. The fat layer ranged from 0. 6 mm to 12. 0 mm. The fat layer was less than 3.0 mm in 6 knees.The ultrasonography results were parallel to those of CT and MRI. The fracture line was shown in 12 knees.Six cases of occult fracture were diagnosed by lipohemarthrosis. X-ray showed lipohemarthrosis in 33 knees and fracture line in 34 knees. Both CT and MRI showed lipohemarthrosis and fracture line. Conclusion Since ultrasonography is very sensitive to the fat layer of joint lipohemarthrosis, with the detection lower limit of 0. 5 mm, it is one of the best imaging methods to detect the joint lipohemarthrosis.