Tretbar Steffen H, Plinkert Peter K, Federspil Philipp A
Division of Ultrasound, Fraunhofer Institute for Biomedical Engineering, St. Ingbert 66386, Germany.
IEEE Trans Biomed Eng. 2009 Mar;56(3):733-40. doi: 10.1109/TBME.2008.2011058. Epub 2009 Jan 23.
The knowledge of skull bone thickness would be helpful for a great variety of surgical interventions of the head. Ultrasound (US) can offer this information intraoperatively in real time. A-mode US measurements of skull bone thickness were performed with different pulse characteristics: 1) in water and 2) by directly coupling a 2.25-MHz US transducer integrated in a handpiece with a soft delay line using coded excitation (CE) (SonoPointer). Mechanical measurements by calipers served as controls. The specimen were 16 nonselected human cadaveric skull bones preserved with formaldehyde. The average difference between the bone thickness measured by the SonoPointer and the mechanical control measurements was 0.04 +/- 0.62 mm. The 95% limits of agreement between the two methods were -1.18 and 1.25 mm. However, even the gold standard of two repeated caliper measurements had limits of agreement of -0.4 and 0.42 mm. Using a standard US pulse in water, only 62.5% sample points were measurable, whereas the SonoPointer produced the thickness measurement in 97.9% of points. CE proved to be superior to single burst or needle US pulses. A-mode US measurements of skull bone thickness using the SonoPointer are feasible. It may provide valuable information on skull bone thickness, e.g., for osteosynthesis, calvarial split bone harvesting, implantation of hearing devices, osseointegrated titanium fixtures, and skull base surgery.
了解颅骨厚度有助于进行多种头部外科手术。超声（US）可在术中实时提供该信息。使用不同脉冲特性进行了颅骨厚度的A模式超声测量：1）在水中测量；2）通过将集成在手持件中的2.25MHz超声换能器与带有编码激励（CE）（SonoPointer）的软延迟线直接耦合进行测量。用卡尺进行的机械测量作为对照。标本为16块未经挑选的用甲醛保存的人类尸体颅骨。SonoPointer测量的骨厚度与机械对照测量之间的平均差异为0.04±0.62mm。两种方法之间的95%一致性界限为-1.18和1.25mm。然而，即使是两次重复卡尺测量的金标准，其一致性界限也为-0.4和0.42mm。在水中使用标准超声脉冲时，只有62.5%的采样点可测量，而SonoPointer在97.9%的点上进行了厚度测量。事实证明，编码激励优于单次脉冲或穿刺超声脉冲。使用SonoPointer进行颅骨厚度的A模式超声测量是可行的。它可能为颅骨厚度提供有价值的信息，例如用于骨合成、颅骨劈开取骨、听力装置植入、骨整合钛固定装置以及颅底手术。
