Burn Institute, Department of Burn and Plastic Surgery, First Affiliated Hospital to General Hospital of PLA, Beijing 100048, China.
Injury. 2012 Sep;43(9):1445-50. doi: 10.1016/j.injury.2011.06.416. Epub 2011 Jul 20.
To study the clinical application of MRI (magnetic resonance imaging) and MRA (MR angiography) technologies for examining the imaging characteristics of muscular and vascular injuries following high-voltage electrical burns.
MRI and MRA examinations were conducted on 18 upper limbs and 8 lower limbs of 18 patients with high-voltage electric burns. Exploratory operations were performed on the necrotic muscle and injured vessels that had abnormal MRI and MRA signals. The necrotic muscle and embolised vessels were removed, and the muscle viability was tested. Meanwhile, histological examinations of the necrotic muscle and injured vessels were performed.
Abnormal signals from the MRI were observed from the 18 upper limbs and 8 lower limbs of these patients. Two kinds of T1-weighted image signals were observed in the necrotic muscle. One form of signal enhancement indicated that the muscular tissue was necrotic, whereby a distinct demarcation was observed between necrotic and normal tissues. The other result was characterised by no signal enhancement in the area of the vessel where blood flow was entirely occluded and the muscle was entirely necrotic. The signal of the T2-weighted image was significantly enhanced in edematous and necrotic muscles and was higher than that of the T1-weighted image. However, the enhancement of the T2-weighted signal exhibited an uneven floccus appearance and had no distinct boundary. MRA of the 18 upper limbs and 8 lower limbs were abnormal and the main pathological manifestations included circuitous arteries and thromboses. The necrotic muscle and injured vessels that were found by MRI and MRA were removed upon exploratory surgery.
Specific MRI and MRA imaging characteristics can be observed in muscular and vascular injures following high-voltage electrical burns. MRI and MRA were very useful for assessing the scope and degree of injury following high-voltage electrical burns, which was helpful to guide the explorative surgery.
研究 MRI（磁共振成像）和 MRA（磁共振血管造影）技术在检查高压电烧伤后肌肉和血管损伤的临床应用。
对 18 例高压电烧伤上肢和 8 例下肢进行 MRI 和 MRA 检查。对 MRI 和 MRA 信号异常的坏死肌肉和损伤血管进行探查性手术。切除坏死肌肉和栓塞血管，并对肌肉活力进行检测。同时，对坏死肌肉和损伤血管进行组织学检查。
18 例上肢和 8 例下肢患者 MRI 均观察到异常信号。坏死肌肉中观察到两种 T1 加权图像信号。一种信号增强形式表明肌肉组织坏死，坏死组织与正常组织之间有明显的界限。另一种结果是在完全闭塞血流且肌肉完全坏死的血管区域无信号增强。T2 加权图像的信号在水肿和坏死肌肉中明显增强，且高于 T1 加权图像。然而，T2 加权信号的增强呈不均匀的绒毛状，且无明显边界。18 例上肢和 8 例下肢的 MRA 均异常，主要病理表现包括迂曲的动脉和血栓形成。MRI 和 MRA 发现的坏死肌肉和损伤血管在探查性手术后被切除。
高压电烧伤后肌肉和血管损伤可观察到特定的 MRI 和 MRA 影像学特征。MRI 和 MRA 对评估高压电烧伤后损伤的范围和程度非常有用，有助于指导探查性手术。
