Ning Tao, Mei Siwei, Ma Mingming, Ruan Xiaojun, Lan Shi, Fu Yongbin
Orthopedic Microrepair and Reconstruction Ward, Fuyang People's Hospital, Fuyang, China.
Orthopedic Microsurgery Repair and Reconstruction Ward, Orthopedic Microrepair and Reconstruction Ward of Fuyang People's Hospital Affiliated to Anhui Medical University, Fuyang, China.
Medicine (Baltimore). 2025 Jun 20;104(25):e42906. doi: 10.1097/MD.0000000000042906.
Morel-Lavallée lesions (MLLs) are uncommon closed soft tissue injuries often arising from blunt trauma, characterized by a separation between the subcutaneous tissue and the underlying fascia, leading to fluid accumulation. This case report aims to enhance the understanding of ultrasonographic features associated with MLLs, supported by data from a patient with a confirmed MLL verified through surgical intervention or magnetic resonance imaging (MRI). A 45-year-old male presented with a history of lower leg trauma, sustained approximately 18 days prior to the initial ultrasonographic assessment. Comparative analysis was performed using a dataset of ultrasound imaging records from 37 patients with MLLs, confirmed through surgical or MRI evaluation between April 2019 and October 2023. Parameters examined included injury etiology, interval from trauma to ultrasound assessment, lesion location and dimensions, echotexture, presence or absence of a capsule, and color Doppler flow imaging (CDFI) findings for blood flow in and around the lesion. In this case, the patient exhibited a traumatic injury to the calf, a frequent site for MLLs, accounting for 18 of the 37 cases. The average lesion area was 15.9 cm², with the lesion appearing hypoechoic on ultrasound. Further assessment indicated heterogeneous echotexture within the lesion, presenting scattered and linear hyperechoic regions. A well-defined boundary encapsulated the lesion, consistent with findings in 34 of the 37 cases. CDFI showed an absence of internal blood flow within the lesion and minimal blood flow in the perilesional tissue, a pattern observed in 2 cases in the broader dataset. In conclusion, this report elucidates the typical ultrasonographic characteristics of MLLs, marked by hypoechoic presentation with a well-defined boundary and absence of internal or perilesional blood flow signals on CDFI. These findings contribute valuable insights into the sonographic diagnosis of MLLs, reinforcing ultrasound's role as a primary imaging modality for evaluating complex soft tissue injuries.
莫雷尔-拉瓦利损伤（MLLs）是一种罕见的闭合性软组织损伤，常由钝性创伤引起，其特征是皮下组织与深层筋膜分离，导致液体聚集。本病例报告旨在通过手术干预或磁共振成像（MRI）确诊为MLL的患者数据，增强对与MLL相关超声特征的理解。一名45岁男性，有小腿外伤史，在首次超声评估前约18天受伤。使用2019年4月至2023年10月期间经手术或MRI评估确诊为MLL的37例患者的超声成像记录数据集进行对比分析。检查的参数包括损伤病因、从创伤到超声评估的间隔时间、病变位置和大小、回声质地、有无包膜以及病变内和周围血流的彩色多普勒血流成像（CDFI）结果。在本病例中，患者小腿出现创伤性损伤，这是MLL的常见部位，在37例病例中有18例发生在此处。病变平均面积为15.9平方厘米，超声显示病变呈低回声。进一步评估表明病变内回声质地不均匀，有散在的线性高回声区域。病变有明确的边界包膜，与37例中的34例结果一致。CDFI显示病变内无内部血流，病变周围组织血流极少，在更广泛的数据集中有2例观察到这种模式。总之，本报告阐明了MLL的典型超声特征，其特点是低回声表现、边界明确，CDFI上无内部或病变周围血流信号。这些发现为MLL的超声诊断提供了有价值的见解，强化了超声作为评估复杂软组织损伤的主要成像方式的作用。
