CAJ | 학술논문

目的探讨超声造影技术对猪肢体枪弹伤失活组织区域判定的价值.方法利用53式滑膛枪建立猪肢体软组织枪击伤模型,应用常规超声及超声造影技术观测猪伤肢原发伤道及其周围软组织声像图表现,并与病理结果对比分析.结果常规超声显像猪肢体枪击伤原发伤道呈走行较清晰的管道状回声,伤道内部回声可随时间延长而发生变化.致伤区超声造影后除原发伤道显示为充盈缺损区外,紧邻伤道周围的部分组织也可呈充盈缺损表现,病理显示充盈缺损区均为失活坏死组织,而造影后伤道周围组织的不均质低增强表现以及最外围的环状高增强表现病理提示分别为以变性组织改变为主和小血管扩张充血改变为主.结论常规超声可判断猪肢体枪弹伤致伤区原发伤道的走行,而超声造影技术则可以精细识别致伤区域失活组织,两者联合应用有助于促进枪弹伤救治水平的提高.
목적 탐토초성조영기술대저지체창탄상실활조직구역판정적개치.방법 이용53식활당창건립저지체연조직창격상모형,응용상규초성급초성조영기술관측저상지원발상도급기주위연조직성상도표현,병여병리결과대비분석.결과 상규초성현상저지체창격상원발상도정주행교청석적관도상회성,상도내부회성가수시간연장이발생변화.치상구초성조영후제원발상도현시위충영결손구외,긴린상도주위적부분조직야가정충영결손표현,병리현시충영결손구균위실활배사조직,이조영후상도주위조직적불균질저증강표현이급최외위적배상고증강표현병리제시분별위이변성조직개변위주화소혈관확장충혈개변위주.결론 상규초성가판단저지체창탄상치상구원발상도적주행,이초성조영기술칙가이정세식별치상구역실활조직,량자연합응용유조우촉진창탄상구치수평적제고.
Objective To explore the value of the determination of the devitalized tissue area of bullet wounds in the pig extremities by contrast-enhanced ultrasound(CEUS).Methods A model of bullet wounds to the pig limb soft tissue was constructed with a model 53 smoothbore.The sonographic features of the soft tissue of and around the primary traumatic channel of the pig extremities were observed by routine ultrasound and CEUS and compared with the pathological findings.Results The primary traumatic channel of bullet wounds to the pig extremities produced clearer tubular echoes under routine ultrasonic imaging.The echoes from inside the traumatic channel changed with time.Part of tissue close to the periphery of the traumatic channel presented with a filling defect area except the primary traumatic channel after ultrasonic contrast of the traumatogenic area.The pathological examination revealed devitalized necrotic tissues in the filling defect area while the heterogeneous low potentiation of the tissue around and the most peripheral circular high potentiation of the traumatic channel indicated a degenerative tissue change and a small angiectatic change after CEUS.Conclusions Routine ultrasound may determine the run of the primary traumatic channel in the traumatogenic area of bullet wounds to the pig extremities while CEUS may accurately distinguish the devitalized tissue in the traumtogenic area.The combination of both is bound to raise greatly the level of the treatment and cure of bullet wounds.