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目的通过评价儿童早期骨关节结核的超声表现,分析声像图特点,探讨超声在儿童早期骨关节结核中的诊断价值。方法回顾性分析8例经病理证实为儿童骨结核的声像图资料,记录骨破坏的位置、范围、内部回声、周围软组织及关节受累情况等二维灰阶超声表现及血流情况。结果 8例见骨质破坏,表现为强回声骨皮质呈不规则骨质破坏。6例见软组织脓肿,表现为骨破坏区内部及周围见混浊液性区。7例见死骨形成,表现为骨质破坏区内较多斑片状及斑点状强回声。5例见血流信号(3例丰富、1例较丰富、1例少量血流信号),其中2例可探及高阻力动脉血流频谱,另外3例无血流信号。4例见关节积液,表现为关节周围无回声区。3例见软组织肿胀,表现为病灶周围肌层回声减低。1例见骨膜抬高,表现为骨皮质表面完整连续的层状稍高回声。1例见骺软骨及骨骺破坏,表现为正常低-无回声骺软骨及骨骺边缘模糊、回声增高。结论儿童早期骨关节结核的声像图表现具有一定特征性,超声检查结合临床病史、实验室检查及其他影像学检查有助于明确诊断。
Objective To evaluate the ultrasonographic features of early childhood osteoarticular tuberculosis and analyze the features of ultrasonography to explore the diagnostic value of ultrasound in the early childhood osteoarticular tuberculosis. Methods Eight cases of pathologically confirmed bone tuberculosis were retrospectively analyzed. The location, range, internal echo, surrounding soft tissue and the involvement of the joints were observed. The two-dimensional gray scale ultrasound findings and blood flow were recorded. Results 8 cases of bone destruction, the performance of the strong echo cortical bone was irregular bone destruction. 6 cases of soft tissue abscess, the performance of bone destruction within and around the area see the turbid liquid. Seventy cases, such as the formation of sequestrum, showed more patchy and speckled echoes in the bone destruction area. 5 cases of blood flow signal (rich in 3 cases, 1 case of more abundant, 1 case of small blood flow signal), including 2 cases of high resistance to explore the arterial blood flow spectrum, the other 3 cases of blood flow signal. 4 cases of joint effusion, showed no echo around the joint area. 3 cases of soft tissue swelling, the performance of the lesion around the muscular echo reduced. A case of periosteal elevation, the performance of the cortical surface of a complete continuous layer slightly hyperechoic. 1 case of epiphyseal cartilage and epiphyseal damage, manifested as normal low - no epiphyseal epiphyseal epiphyseal edge fuzzy, echo increased. Conclusion Ultrasonography of early childhood osteoarticular tuberculosis has certain characteristics. Ultrasonography combined with clinical history, laboratory tests and other imaging findings can help confirm the diagnosis.