Tsai C C, Lai C S, Yu M L, Chou C K, Lin S D
Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical College, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1996 Apr;12(4):235-40.
Necrotizing fasciitis is a rare and rapid progression soft tissue infection. The only identifiable feature is tissue necrosis along a single fascia plane. Because the skin is initially spared, it is difficult for early recognition prior to extensive tissue destruction. Ultrasonography was used for early diagnosis of this infection in five cases. All 5 patients presented with severe cellulitis. Under the suspicion of necrotizing fasciitis, ultrasonography was performed before surgical debridement. Tissue biopsy was done for histological confirmation of the diagnosis. Three patients were proven to have necrotizing fasciitis and two cellulitis only. The ultrasonographic findings of necrotizing fasciitis included: 1) irregularity of the fascia; 2) abnormal fluid collections along the fascia plane; and 3) diffuse thickening of the fascia when compared with the control site in the normal limb. However, in severe infectious cellulitis, the above mentioned findings were not observed. Our results indicate the usefulness of the ultrasonography for early diagnosis of necrotizing fasciitis.
坏死性筋膜炎是一种罕见且进展迅速的软组织感染。唯一可识别的特征是沿单一筋膜平面的组织坏死。由于皮肤最初未受影响，在广泛组织破坏之前很难早期识别。超声检查用于5例该感染的早期诊断。所有5例患者均表现为严重蜂窝织炎。在怀疑为坏死性筋膜炎的情况下，在手术清创前进行了超声检查。进行组织活检以进行组织学诊断确认。3例患者被证实患有坏死性筋膜炎，2例仅为蜂窝织炎。坏死性筋膜炎的超声检查结果包括：1）筋膜不规则；2）沿筋膜平面有异常液体积聚；3）与正常肢体对照部位相比，筋膜弥漫性增厚。然而，在严重感染性蜂窝织炎中，未观察到上述发现。我们的结果表明超声检查对坏死性筋膜炎的早期诊断有用。
