Brink J A, Sheets P W, Dines K A, Etchison M R, Hanke C W, Sadove A M
Invest Radiol. 1986 Aug;21(8):645-51. doi: 10.1097/00004424-198608000-00008.
Early excision and grafting of full thickness burns has been shown to decrease morbidity and mortality. Errors made in assessing acute burn depth are common and result in prolonged hospitalization in expectant healing of full-thickness burns and in unnecessary excision and grafting of potentially regenerative partial-thickness burns. High-frequency ultrasonic imaging may be a noninvasive, convenient means of quantitating burn depth. A depth analysis system for imaging burned skin was developed using a high-frequency 18.5 MHz (nominal 25 MHz) pulse-echo ultrasound system with a longitudinal resolution of 86 mu. Five adult mini-swine (15 kg) were burned with a temperature-(190 degrees C) and pressure-controlled (236 g/cm2) burning iron. A series of burn durations (1-45 seconds) was used to inflict partial- and full-thickness burns of various depths. Ultrasonic scans of the acutely excised burns were performed across the lateral margin of the burn, including adjacent normal skin to serve as control. Direct histologic comparison was made with each scan plane. Average burn and normal skin depth measurements were made by independent observers for 34 scans and corresponding histologic sections. A significant correlation was achieved between burn depth and percent burn (burn depth/adjacent normal skin depth) as measured by ultrasound and histology (R = 0.90, t = 11.2, P less than .001).
早期切除并移植全层烧伤创面已被证明可降低发病率和死亡率。评估急性烧伤深度时出现的误差很常见，会导致全层烧伤创面期待愈合时住院时间延长，以及对可能可再生的浅度烧伤进行不必要的切除和移植。高频超声成像可能是一种无创、便捷的烧伤深度定量方法。利用一台纵向分辨率为86微米的高频18.5兆赫（标称25兆赫）脉冲回波超声系统，开发了一种用于烧伤皮肤成像的深度分析系统。选用5只成年小型猪（体重15千克），用温度为190摄氏度、压力控制为236克/平方厘米的烙铁进行烧伤。采用一系列烧伤持续时间（1至45秒）造成不同深度的浅度和全层烧伤。在烧伤创面的外侧边缘进行急性切除烧伤的超声扫描，包括相邻的正常皮肤作为对照。对每个扫描平面进行直接组织学比较。由独立观察者对34次扫描及相应的组织学切片进行平均烧伤深度和正常皮肤深度测量。超声和组织学测量的烧伤深度与烧伤百分比（烧伤深度/相邻正常皮肤深度）之间存在显著相关性（R = 0.90，t = 11.2，P < 0.001）。
