Use of ultrasound in assessment of necrotic tissue in pressure ulcers with adjacent undermining.
Use of ultrasound in assessment of necrotic tissue in pressure ulcers with adjacent undermining.
复制标题
使用超声波评估邻近破坏的压疮中的坏死组织。
DOI：
10.12968/jowc.2011.20.11.503
复制
发表时间：
2011
影响因子：
1.9
通讯作者：
K. Tabata
中科院分区：
文献类型：
--
作者：
M. Ueta;J. Sugama;C. Konya;J. Matsuo;M. Matsumoto;K. Yabunaka;T. Nakatani;K. Tabata
目的
目的：揭示压疮伴潜行损伤时不可见坏死组织的超声声像图特征，并对声像图进行客观描述。还确定了受损坏死组织的特定图像的预测有效性。
方法
使用数字超声（12 MHz线性换能器，MyLab 25; Hitachi Medical Corporation），我们每2周对PU进行一次破坏成像。与此同时，还通过PU评估工具WGN-R对PU进行监测。
结果
10名患者有11个溃疡伴破坏，所有溃疡均位于骶骨区域。坏死组织呈高回声，无层次，边界不清，灰度不均（云状图像）。肉芽组织表现为低回声图像，无分层，分辨率较低，灰度均匀。坏死组织（84.0）和肉芽组织（53.9）的像素均匀性与未损伤组织（65.5;分别为p=0.000和0.005）之间存在显著差异。云状图像诊断乳腺癌的敏感性、特异性、阳性预测值和阴性预测值分别为87.5%、91.7%、77.8%和95.6%。
结论
结果表明，云状图像是PU中不可见坏死组织的最有用的诊断指标，并且是PU愈合的最佳预后指标。
利益申报
作者没有利益冲突需要声明。本研究没有外部资金来源。
OBJECTIVE
To reveal the specific ultrasonic imaging findings of non-visible necrotic tissue in pressure ulcers (PUs) with undermining and describe the images objectively. The predictive validity of the specific images of the undermined necrotic tissue was also determined.
METHOD
Using digital ultrasonography (12 MHz linear transducer, MyLab25; Hitachi Medical Corporation), we imaged PUs with undermining every 2 weeks. PUs were also monitored by DESIGN-R, a PU assessment tool, at the same time.
RESULTS
Ten patients had 11 PUs with undermining and all ulcers were located in the sacral region. The necrotic tissue showed high echogenicity with no layers, unclear borders and an uneven gray level (cloud-like image). Granulation tissue appeared as a low echoic image which had no layers, was of coarse resolution and an even gray level. There were significant differences between the pixel uniformity of the necrotic tissue (84.0) and granulation tissue (53.9) compared with uninjured tissue (65.5; p=0.000 and 0.005, respectively). The sensitivity, specificity, and positive and negative predictive values of cloud-like image were 87.5%, 91.7%, 77.8% and 95.6%, respectively.
CONCLUSION
The results suggest that cloud-like image is the most useful diagnostic indicator for non-visible necrotic tissue in PUs with undermining and is the best prognostic indicator for PU healing.
DECLARATION OF INTEREST
The authors have no conflicts of interest to declare. There were no external sources of funding for this study.