彩色多普勒超声及X线平片对异位骨化诊断的比较

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

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。

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（P〈0.01）.Conclusion CDFI is effective on the early diagnosis of heterotopic ossification.