Jiang Xue, Li Feng, Chi Yunfei, Chen Xin, Luo Yukun, Ye Qinggui, Song Wenjing, Li Guoping
Department of Ultrasound Diagnosis, The Fourth Medical Center of PLA General Hospital, Beijing, China.
Burns and Plastic Department, The Fourth Medical Center of PLA General Hospital, Beijing, China.
Ann Transl Med. 2021 Aug;9(16):1315. doi: 10.21037/atm-21-3715.
The diagnosis of burn depth often relies on the subjective judgment of plastic surgeons. Contrast-enhanced ultrasound (CEUS) can visualize the microcirculation well and has potential value in diagnosing the depth of burn wounds. We assessed the depth of the burn wounds by CEUS, and compared the results with histological examination.
Two rhesus monkeys were used, and multiple burn wounds with different depths were made on their backs. The echo of the dermis and subcutaneous tissue were observed for each wound, and the thickness of the dermis was measured. CEUS was performed to evaluate the depth of burn wounds and compared with pathological results.
(I) After scalding, dermal tissue edema occurred, and the thickness of the dermis measured by a US tended to increase gradually, related to the time of scalding and the order of measurement. (II) With the prolongation of the burn time, the depth of filling by contrast agent gradually increased, from the superficial dermis to the deep dermis and subcutaneous tissue, indicating that the depth of tissue damage gradually increased. This was consistent with the pathological observation. The thickness of the healthy dermis was about 1.3-1.8 mm, and 2.7-4.1 mm after scalding. The depth of the burn wounds was 0.9-4.1 mm, accounting for 32-100% of the full skin thickness.
CEUS is a convenient and fast examination method that is consistent with pathological diagnosis of the depth of burn wounds and could prove valuable for the accurate assessment of burn injuries.
烧伤深度的诊断通常依赖于整形外科医生的主观判断。超声造影（CEUS）能够很好地显示微循环，在烧伤创面深度诊断方面具有潜在价值。我们通过CEUS评估烧伤创面深度，并将结果与组织学检查进行比较。
使用两只恒河猴，在其背部制造多个不同深度的烧伤创面。观察每个创面真皮和皮下组织的回声，并测量真皮厚度。进行CEUS以评估烧伤创面深度，并与病理结果进行比较。
（I）烫伤后，真皮组织出现水肿，超声测量的真皮厚度倾向于逐渐增加，这与烫伤时间和测量顺序有关。（II）随着烧伤时间的延长，造影剂填充深度逐渐增加，从浅表真皮到深部真皮和皮下组织，表明组织损伤深度逐渐增加。这与病理观察结果一致。正常真皮厚度约为1.3 - 1.8mm，烫伤后为2.7 - 4.1mm。烧伤创面深度为0.9 - 4.1mm，占全层皮肤厚度的32% - 100%。
CEUS是一种方便快捷的检查方法，与烧伤创面深度的病理诊断结果一致，对准确评估烧伤损伤可能具有重要价值。
