A novel quantitative approach to evaluate femoral head perfusion by contrast-enhanced ultrasound: A pilot study in infants with developmental dysplasia of the hip.
A novel quantitative approach to evaluate femoral head perfusion by contrast-enhanced ultrasound: A pilot study in infants with developmental dysplasia of the hip.
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一种通过对比增强超声评估股骨头灌注的新定量方法：对患有发育性髋关节发育不良的婴儿进行的初步研究。
DOI：
10.1109/ius51837.2023.10307817
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Back,SusanJ
中科院分区：
文献类型：
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作者：
Sultan,LaithR;Alves,AndressaGF;Morgan,TrudyA;Sridharan,Anush;Batley,Morgan;Darge,Kassa;Sankar,WudbhavN;Back,SusanJ
缺血性坏死（AVN）是一种主要的发病率，可发生在髋关节发育不良手术复位后。术中早期检测股骨头灌注的变化可能有助于发现有AVN风险的髋关节，并指导术中管理。超声造影（CEUS）可用于股骨头灌注的可视化。在这项研究中，我们评估了定量CEUS技术，以评估股骨头灌注手术前和手术后的减少。在手术复位和铸造之前和之后，在超声造影剂的团注之后获得CEUS图像。一种称为三角投影的图像处理技术被用来量化髋关节灌注，测量峰值增强（PE）和灌注指数（PI）。我们分析了8例患者的髋关节CEUS图像，其中7例为女性，年龄从4个月到1岁不等。在5个髋关节中，术后灌注增加，平均术前PE为6.7 ±2.5（± SE），PI为10.5 ±6.3;复位后PE为13.1±6.1（p=0.07），PI为14.2 ±6.2（p=0.008）。观察到在软骨股骨骺的中央方面，对比度可视化的变化更大。所提出的技术可以量化术前和术后灌注变化的CEUS图像在发育性发育不良的患者。这种定量技术可以提供一个更客观和准确的评估股骨头灌注的变化，可能有可能是发展AVN的风险指示。
Avascular necrosis (AVN) is a major morbidity that can occur after surgical reduction of a hip with developmental dysplasia. Early detection of changes in femoral head perfusion during surgery may help detect a hip at risk for AVN and guide intraoperative management. Contrast-enhanced ultrasound (CEUS) can be employed for visualization of femoral head perfusion. In this study we evaluate a quantitative CEUS technique to assess femoral head perfusion pre- and post-surgical reduction. CEUS images were obtained following a bolus injection of an ultrasound contrast agent, prior to and again following surgical reduction and casting. An image processing technique called delta projection was used to quantify hip perfusion, measuring peak enhancement (PE) and perfusion index (PI). We analyzed CEUS images of the hips of eight patients, including seven females, whose ages ranged from 4 months to 1 year. In five hips, perfusion increased following surgery, with a mean pre-surgery PE of 6.7 ±2.5(± SE) and PI of 10.5 ±6.3; and a post-reduction PE of 13.1±6.1 (p=0.07) and PI of 14.2 ±6.2 (p=0.008). The change in contrast visualization was observed to be greater within the central aspect of the cartilaginous femoral epiphysis. The proposed technique can quantify pre- and post-surgical perfusion changes on CEUS images in patients with developmental dysplasia. This quantitative technique may provide a more objective and accurate assessment of changes in femoral head perfusion that may have the potential to be indicative of the risk of developing AVN.