Serafin-Król Małgorzata, Król Radosław, Jedrzejczyk Maciej, Ziólkowski Marcin, Mlosek Robert, Jakubowski Wiesław, Deszczyński Jarosław
Zakład Diagnostyki Obrazowej, II Wydział Lekarski, AM, Wojewódzki Szpital Bródnowski, Warszawa.
Ortop Traumatol Rehabil. 2008 Mar-Apr;10(2):131-6.
Ultrasonography performed shortly after a direct or indirect muscle trauma may be confusing. The extent of a muscular tear can be difficult to assess because of oedema, intramuscular haematomas and red infarct. The aim of this study was to find out if it is possible to assess the extent of muscular lesions shortly (6 to 48 hours) after a trauma with improved accuracy using contrast-enhanced gray-scale ultrasonography.
Ultrasonograp[hic examinations were carried out in 7 male football players 8 to 48 hours following a direct (4) and indirect (3) trauma, and one female dancer with an indirect muscle trauma. Standard B-mode US examinations and gray-scale contrast-enhanced US after administration of Sonovue (Altana Pharma, Konstanz, Germany) were performed in all patients to evaluate the margins and size of the posttraumatic lesions. In contrast-enhanced studies, the size of the structural lesion in the muscle and space that might correspond to the muscle tear were measured.
In all 8 cases, the borders of the muscular lesions were better delineated following administration of the contrast agent as a poorly and irregularly enhanced or non-enhancing areas. In 3 cases of direct and 2 cases of indirect trauma, the lesions were bigger in the contrast-enhanced study, and in one case of direct trauma and 2 indirect lesions, they were smaller following contrast-enhancement.
These preliminary results indicate that gray-scale contrast-enhanced US of muscle can be helpful in the assessment of the extent of muscular trauma in dubious cases during the early post-injury period.
在直接或间接肌肉创伤后不久进行超声检查可能会造成混淆。由于水肿、肌内血肿和红色梗死，肌肉撕裂的程度可能难以评估。本研究的目的是确定在创伤后不久（6至48小时）使用超声造影增强灰阶超声检查是否有可能更准确地评估肌肉损伤的程度。
对7名男性足球运动员在直接（4例）和间接（3例）创伤后8至48小时以及1名有间接肌肉创伤的女性舞蹈演员进行了超声检查。对所有患者进行标准B模式超声检查以及在注射声诺维（德国康斯坦茨阿尔塔纳制药公司）后进行灰阶超声造影，以评估创伤后病变的边缘和大小。在超声造影研究中，测量肌肉中可能与肌肉撕裂相对应的结构病变的大小和范围。
在所有8例病例中，注射造影剂后，肌肉病变的边界作为增强不佳、不规则增强或无增强区域能得到更好的描绘。在3例直接创伤和2例间接创伤病例中，超声造影研究中的病变更大，而在1例直接创伤和2例间接创伤病例中，超声造影增强后病变更小。
这些初步结果表明，在损伤后早期的可疑病例中，肌肉灰阶超声造影有助于评估肌肉创伤的程度。
