【作者】 郑艳芬；

【导师】 康春松；

【作者基本信息】 山西医科大学 ， 影像超声医学， 2003， 硕士

【摘要】 目的：研究高频超声显示皮肤及皮神经的可行性；高频超声测量皮肤各层结构及皮神经的准确性；观察带状疱疹患者局部皮肤及皮神经病理解剖变化所致的高频超声声像图改变，为进一步研究带状疱疹患者未出疹前或无疹型及后遗神经痛的声像图改变提供实验依据，进而为临床早期诊断，减少误诊寻求影像学依据。方法：分为动物实验及临床实验两部分。动物实验部分对刚处死的5只猪两侧胸肋部连皮带骨肉共10块进行高频超声检查，分别在解剖前及解剖后用针标定皮肤各层结构后进行检测，并与大体标本及组织学检查对照，以验证该方法的可行性并确定正常皮肤、皮下组织及皮神经的超声声像图特征。临床实验部分检测带状疱疹患者37例，共77处病变，后遗神经痛患者7例，共17处病变，均以同一患者健侧对应部位做对照，观察皮肤及皮下组织厚度、回声特征及皮神经的宽度、回声特征。结果：高频超声所示皮肤各层结构及皮神经声像图与大体标本及组织学所见正确对应；皮肤厚度、皮下组织厚度及皮神经直径的超声及大体标本测值经统计学处理无差异性(P＞0.05)；带状疱疹患者皮肤、皮下组织均增厚(P＜0.01)，回声减低;受累皮神经增粗(P<0.01)，回声减低，线性结构模糊。后遗神经痛患者皮肤、皮下组织改变不明显(P>0.05)，受累皮神经增粗(P<0.01)，回声增强，线性结构模糊。结论:高频超声可正确认识皮肤、皮下组织及皮神经结构;高频超声测量皮肤各层结构及皮神经方法简单、准确;高频超声可客观显示带状疮疹患者皮肤、皮神经炎性病理改变异常声像图。更多还原

【Abstract】 Objective : To study the feasibility of using high frequence ultrasound scan to show skin and skin nerves ; To study the accuracy of using high frequence ultrasound to measure each layer of skin and skin nerves ; To observe the changes of image features of high frequence ultrasound , which is caused by the pathology-anatomy changes in the local skin or peripheral nerves ; In order to provide the base for studying the image changes of herpes zoster ; Further more it provides image base for early diagnosis and reducing the percentage of misdiagnosing . Methods : The experiment was divided into two parts-animal experimental part and clinical one . In the animal experimental part ,10 slices of skin (together with meat) from the chest of five pigs which had been just killed were examined with high frequence ultrasound . Each layer of the skin had been signed with needles separately before and after their analysis . They were also contrasted with whole specimen and the histological examination in order to test the feasibility of the method and to confirm the features of ultrasound images in normal skin , subcutaneous tissue and skinnerves . In the clinical experiment, 37 cases of herpes zoster patients with 77 pathological changes were examined , 7 cases of sequence of neuralgia with 17 pathological changes . They were all compared with the healthy side of the same patient .We observed the thickness of the skin and subcutaneous tissue , the echoing feature and the width of the skin nerves . Results : The image of the structure of skin and skin nerves showed by high frequence ultrasound corresponded with whole specimen and its histological examination exactly . The image that showed the thickness of skin and subcutaneous tissue , the diameters of skin nerves as well as the measurement of the whole specimen had no statistic discrepancy ( P>0.05) . On one hand , the skin and subcutaneous tissue of the herpes zoster patients became thicker (P<0.01),but the ones of the patients who have sequel to neuralgia changed little (P>0.05) . Both of their nerves were widen (P<0.01) . The line structure were all vague . On the other hand , the echo of the nerves is former one was lower , but the latter one’s was stronger . Conclusion : The high frequence ultrasound scan can identify the structure of skin ,subcutaneous tissue and skin nerves exactly .The usage is simple and accurate . At the same time , the highfrequence ultrasound scan can show the inflammatory pathological image of the skin , skin nerves of herpes zoster patients objectively .更多还原