基于超声监测带状疱疹各期皮下组织及皮神经变化的研究

The Changes of Subcutaneous Tissue and Cutaneous Nerve of Herpes Zoster based on Color Doppler Ultrasonography

目的应用彩色多普勒高频超声动态检测同一带状疱疹患者各期皮肤、皮神经及皮下动脉的声像图改变,为早期诊断带状疱疹寻求新的影像学依据。方法对49例确诊为带状疱疹患者,用15MHZ彩色多普勒超声动态观察患者各期病变处皮肤层及皮下组织层厚度、皮神经横截面积和皮下动脉流速,与患者健侧对应部位比较。结果出疹前期及红斑丘疹期患者病变处皮肤层及皮下组织层明显增厚(P<0.01),皮神经横截面积明显增大(P<0.01),皮下动脉流速增快(P<0.01);水疱期皮肤及皮下组织层未见明显增厚(P>0.05),皮下动脉流速未见明显增快(P>0.05),但皮神经横截面积仍然增大(P<0.01)。结论彩色多普勒超声不仅能动态检测带状疱疹患者皮肤和皮神经声像图表现异常,并且通过检测皮下动脉流速的观察,对带状疱疹患者的早期诊断提供了客观影像学依据。

Objective To study the sonographic changes of skin and cutaneous nerves in patients of herpes zoster with Color Doppler ultrasonography. Methods In sixty-eight patients of herpes zoster Color Doppler uhrasonography were performing to examine with thickness and echo feature of the dermal and subcutaneous tissue as well as cross-section area 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 tile stage of preemption and erythema or exanthema, the thickness of skin or subcutaneous tissue was increased （P〈0.01）, The flow rate of subcutaneous arteries or the cross-secion area of the cutaneous nerves were also increased （P〈0. 01）, and the echoes were significantly decreased; at the stage of poulovesicle, the thickness of the skin or subcutaneous tissue was increased （P〉0. 05）, the flow rate of subcutaneous arteries were increased too （P〉0.05）, but the cross-secion area of the cutaneous nerves were increased （P〈0.01）. Conclusion Color Dopplemhrasound can detect abnormal sonographic appearances in the skin, subcutaneous tissue, cutaneous nerves or subcutaneous arteries of patients with early stage herpes zoster. Thus this approach could provide imaging evidence for early clinical diagnosis and reduce misdiagnosis.