RU2201142C2 - Method for evaluating regeneration activity of distraction regenerate - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves carrying out ultrasonic examination of distraction regenerate. Echo density, beam penetration depth and calculated N value are determined using mathematical formula and compared to nomogram. EFFECT: high accuracy of evaluation. 1 dwg, 1 tbl

Description

 The invention relates to medicine, in particular to methods for studying ultrasonographic images of organs and tissues, in particular, is used to assess the distraction regenerate of long tubular bones at the stages of bone lengthening by transosseous osteosynthesis.

A known method for the quantitative assessment of ultrasonographic images of organs and tissues, in which when acquiring an image of an organ or tissue under study, the ultrasonic diagnostic device sensor is pointed at a large blood vessel or heart cavity located in the plane of the object being studied, the maximum power level of the emitted signal is determined at which the prevailing gradation the "gray scale" of the portion of the image corresponding to the cut of the vessel or cavity of the heart is equal to one (Pat. RU 2082319, IPC ⁶ A 61 B 8/08, publ. 2 June 7, 1997, Bull. 18).

 It is known to use ultrasound echography to assess reparative bone formation during lengthening of the limb according to Ilizarov, including longitudinal and transverse scanning of the studied area, namely the distraction regenerate, using an ultrasound sensor with subsequent visualization of the distraction regenerate (Shevtsov V.I., Ermak E.M. Use of ultrasound sonography for assessing reparative bone formation with limb lengthening according to Ilizarov. / Traumatology and orthopedics of Russia. - 1995. - 2. -S. 13-16).

 However, the known method does not allow to obtain a quantitative assessment of the regenerative activity of the distraction regenerate, to individually monitor the dynamics of regenerative activity, which is necessary for timely adjustment of the treatment tactics of the patient.

 The objective of the present invention is to develop a method for assessing the regenerative activity of a distraction regenerate, which allows to obtain a quantitative assessment of the regenerative activity of a distraction regenerate of long tubular bones at different stages of the treatment and rehabilitation process and, comparing the digital parameter with the nomogram, to determine the degree of its regenerative activity.

 The problem is solved in that in a method for assessing the regenerative activity of a distraction regenerate, including installing a sensor above the studied area, its longitudinal scanning with the determination of sound conductivity, an amplitude histogram is analyzed in a selected area of the distraction regenerate and the depth of penetration of the ultrasound beam through the formed distraction regenerate is estimated, the relative exponent N from the ratio N = L / l, where L is the echo density of the section, l is the depth of penetration of the beam (mm), Acquiring value correlated with the data and determine the nomogram normal regenerative activity at N values falling within the normal range, above the normal range - high regenerative activity below - reduced.

 The patented invention is illustrated by a detailed description, clinical example, nomogram and scans.

 Figure 1 shows a nomogram illustrating the dependence of the relative indicator N (relative units) on the treatment period t (months). The numbers indicate the areas: 1 - values corresponding to increased regenerative activity; 2 - values corresponding to normal regenerative activity (normal range); 3 - values corresponding to reduced regenerative activity.

 In FIG. 2 shows a scan of a distraction regenerate. On the left - the studied area of the distraction regenerate is visualized, on the right - the analysis of the amplitude histogram is carried out, where the obtained values of the echo density L are equal to 20 rel.

 Figure 3 shows a scan of the distraction regenerate in the optimal image gain with an estimate of the penetration depth of the ultrasonic beam, where the values of the penetration depth of the ultrasonic beam l equal to 2 cm (20 mm) are obtained.

 The method is carried out in the following way.

 In the process of ultrasound examination of the distraction regenerate, a 7.5 MHz sensor is used. With poor visualization, in addition to the sensor, a gel-containing nozzle is attached. The sensor is installed parallel to the maternal bone of the studied segment and during its longitudinal scanning, the distraction regenerate is visualized. The investigated area of the distraction regenerate is displayed on the monitor screen, which is isolated for analysis of the amplitude histogram. On the selected area of the distraction regenerate, an analysis of the amplitude histogram is carried out, where L is determined - the echo density of the site. With optimal amplification of the investigated area, the penetration depth of the ultrasound beam through the distraction regenerate is estimated, and the obtained value is measured in millimeters. If the penetration depth of the ultrasound beam through the generated distraction regenerate is greater than the thickness of the mother bone, then the penetration depth of the ultrasound beam is taken to be equal to the thickness of the mother bone, which is additionally determined by the thickness of the visible sections of the bone fragments when the sensor is displaced distal or proximal to the studied section of the distraction regenerate.

Based on the data obtained, the relative indicator N (rel.unit) is calculated from the ratio
N = L / l,
where L is the echo density of the plot;
l is the penetration depth of the beam (mm).

 The obtained values are correlated with the data of the nomogram (figure 1) and determine the normal regenerative activity with N values falling in the normal range (region 2), above the normal range (region 1) - increased regenerative activity, below the normal range (region 3) - reduced regenerative activity.

 An example of the method.

 Patient D., 16 years old. Diagnosis: consequences of osteomyelitis. Shortening of the left shoulder 6 cm. Operation: monolocal distraction osteosynthesis of the left shoulder. The fixation stage is 37 days. Regenerate 29 mm.

An ultrasound scan is carried out, a 7.5 MHz sensor is used, and a distraction regenerate is visualized during longitudinal scanning. In the selected area of the distraction regenerate, an analysis of the amplitude histogram is carried out with the determination of the echo density of the area L, which is equal to 20 conventional units (figure 2). Estimate the penetration depth of the ultrasonic beam through the generated distraction regenerate (in mm), which is equal to 20 mm (figure 3). Relative exponent N (relative units) is calculated from the ratio N = L / l, where L is the echo density of the section, l is the depth of penetration of the beam (mm) ^
N = 20/20 = 1.0 (rel. Units)
The obtained values are correlated with the data of the nomogram (Fig. 1), which fall into the range of normal values, evaluate the regenerative activity of the distraction regenerate and determine it as “normal”.

 The proposed method allows in the conditions of transosseous osteosynthesis to diagnose the regenerative activity of a distraction regenerate, to quantify it and accordingly to correct treatment tactics. The implementation of the method is possible at any stage of treatment with an unlimited frequency of examination.

 The proposed method is used in the RRC "WTO". Its implementation is possible in any orthopedic and traumatology department using an ultrasound diagnostic unit.

Claims (1)

 A method for evaluating the regenerative activity of a distraction regenerator, including installing a sensor over the studied area, its longitudinal scanning with the determination of sound conductivity, characterized in that the amplitude histogram is analyzed on the selected area of the distraction regenerate and the depth of penetration of the ultrasound beam through the formed distraction regenerate is estimated, the relative index N is calculated from ratios N = L / 1, where L is the echo density of the section, l is the depth of penetration of the beam (mm) obtained The ratios correlate with the data of the nomogram and determine the normal reparative activity with N values falling in the normal range, above the normal range - increased regenerative activity, lower - lower.

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