Gottlöber P, Bezold G, Weber L, Gourmelon P, Cosset J M, Bähren W, Hald H J, Fliedner T M, Peter R U
Department of Dermatology, Federal Armed Forces Hospital, Ulm, Germany.
J Am Acad Dermatol. 2000 Mar;42(3):453-8. doi: 10.1016/s0190-9622(00)90218-4.
Eleven male Georgian soldiers were accidentally exposed to radiation by cesium 137 during their training in a military exercise camp in Lilo, Georgia between November 1996 and May 1997.
The characteristic sequelae of accidental cutaneous irradiation and available diagnostic methods are described.
Magnetic resonance imaging (MRI) of radiation ulcers was performed in all patients; thermography was performed in 2. In 7 patients ulcers and white macules were examined with high-frequency 20 MHz sonography; histologic results were obtained from all patients.
Predominant lesions were radiation ulcers in 11 patients and white hairless macules in 7. MRI showed ulcers down to the muscles and an increase of signal intensity in the musculature in 9 cases. The corresponding muscle histology demonstrated vasculitis in 7 patients and necrosis in 2. In 2 patients, MRI signal intensity of the musculature was normal. In 3 patients, 20 MHz sonography showed dermal defects; 1 patient had cutaneous fibrosis. Thermography demonstrated hypothermic zones with extended inflammatory zones adjacent to the radiation ulcers in both patients examined.
High-frequency 20 MHz sonography, MRI, and thermography are useful noninvasive methods for diagnosis of the extent of cutaneous radiation syndrome and for therapy planning.
1996年11月至1997年5月期间，11名格鲁吉亚男性士兵在格鲁吉亚利洛的一个军事训练营进行训练时意外受到铯137辐射。
描述意外皮肤照射的特征性后遗症及可用的诊断方法。
对所有患者进行放射性溃疡的磁共振成像（MRI）检查；2例患者进行了热成像检查。7例患者的溃疡和白色斑片采用20兆赫高频超声检查；所有患者均获得了组织学结果。
主要病变为11例放射性溃疡和7例白色无毛斑片。MRI显示9例患者的溃疡深达肌肉，肌肉组织信号强度增加。相应的肌肉组织学检查显示7例患者有血管炎，2例有坏死。2例患者肌肉组织的MRI信号强度正常。3例患者经20兆赫超声检查显示真皮缺损；1例患者有皮肤纤维化。热成像显示，在接受检查的2例患者中，放射性溃疡附近有低温区，炎症区扩大。
20兆赫高频超声、MRI和热成像对于诊断皮肤辐射综合征的范围及制定治疗方案是有用的非侵入性方法。
