摘要
目的:探讨高频超声及彩色多普勒超声在小儿髋关节滑膜炎诊断中的应用价值。方法:选取2021年1月-2023年1月芜湖市中医医院儿童骨科收治的120例小儿髋关节滑膜炎患者,应用高频超声及彩色多普勒超声进行检查,观察双侧髋关节囊厚度,股骨颈前隐窝是否有积液,骨及关节软骨回声结构,测量股骨颈前间隙宽度,前隐窝积液宽度及滑膜厚度,彩色多普勒血流显像观察关节囊滑膜血流信号,对血流情况进行分级评估和测量。结果:高频超声检查120例患儿中,关节囊肿胀型32例,表现为股骨颈前间隙增宽,股骨颈处关节囊肿胀,关节囊向前方隆起,滑膜面回声减低,和健侧相比,宽度差明显>1mm。关节囊积液型88例,表现为髋关节关节囊滑膜面分离,可见无回声暗区,宽度2~10mm。120例患者彩色多普勒血流显像结果显示,患侧126个关节中0级29个,1级35个,2级50个,3级12个,健侧(114个关节)中0级62个,1级30个,2级22个,3级0个,组间分布差异具有统计学意义(P<0.05)。患侧平均峰值流速为(18.21±6.21)cm/s,健侧平均峰值流速为(7.52±3.62)cm/s,组间差异具有统计学意义(P<0.05)。结论:高频超声可以清晰地显示髋关节结构,定量测量相关指标,彩色多普勒超声可以提供髋关节滑膜血流信息,有助于关节囊肿胀型滑膜炎的诊断,且可以评估滑膜炎的预后状况,结合两者可以对小儿髋关节滑膜炎的诊断和治疗进行全程评估,可作为我们检查小儿髋关节滑膜炎的首选检查方式。
Objective To explore the value of high-frequency ultrasound and Color Doppler ultrasound in the diagnosis of hip synovitis in children.Methods 120 children with hip synovitis admitted to Wuhu Traditional Chinese Medicine Hospital from January 2021 to January 2023 were selected.High frequency and color Doppler ultrasound were used to examine the thickness of bilateral hip articular capsule,whether there was fluid accumulation in the anterior recess of neck of femur,and the echo structure of bone and articular cartilage.The width of the anterior space of neck of femur,the width of fluid accumulation in the anterior recess,and the thickness of synovium were measured.Color Doppler flow imaging was used to observe the synovium blood flow signals of the articular capsule,to perform a graded evaluation and measurement of blood flow.Results Among 120 cases of children,32 cases were diagnosed as swollen joint cysts,which showed that the anterior space of the neck of femur was widened,the joint cysts at the neck of femur were swollen,the articular capsule was raised forward,and the echo of the synovial surface was reduced.Compared with the healthy side,the width difference was significantly>1 mm.88 cases of articular capsule hydrops type showed separation of synovial surface of the articular capsule of the hip joint,and anechoic dark area was visible,with a width of 2~10 mm.Among 120 patients with color Doppler blood flow imaging,there were 29 joints at level 0,35 joints at level 1,50 joints at level 2,and 12 joints at level 3.Among the healthy side(114 cases),there were 62 joints of grade 0,30 jointsof grade 1,22 joints of grade 2,and 0 joint of grade 3.The distribution difference between the two groups was statistically significant.The average peak flow velocity on the affected side was(18.21±6.21)cm/s,and the average peak flow velocity on the healthy side was(7.52±3.62)cm/s.The difference between the two groups was statistically significant(P<0.05).Conclusions High-frequency ultrasound can clearly display the structure of the hip joint,quantitatively measure the relevant indicators.Color Doppler ultrasound can provide hip synovial blood flow information,help the diagnosis of joint capsule swelling synovitis,and can assess the prognosis of synovitis.Combined with the two we can evaluate the diagnosis and treatment of pediatric hip synovitis,which can be used as our preferred examination method for detecting pediatric hip synovitis.
作者
杨迎青
张军
孔祥海
丁通
YANG Yingqing;ZHANG Jun;KONG Xianghai;DING Tong(Ultrasound Department,Wuhu Traditional Chinese Medicine Hospital,Wuhu,Anhui 241000,China;Children’s Orthopedics Department,Wuhu Traditional Chinese Medicine Hospital,Wuhu,Anhui 241000,China)
出处
《医药前沿》
2023年第24期21-24,共4页
Journal of Frontiers of Medicine
基金
芜湖市卫生健康委科研项目(WHWJ2021y055)
芜湖市卫生健康委科研项目(WHWJ2021y063)。
关键词
小儿髋关节滑膜炎
高频超声
彩色多普勒超声
Pediatric hip synovitis
High-frequency ultrasound
Color Doppler ultrasound
