Abstract：
UNASSIGNED: Given the possible radiation damage and inaccuracy of radiological investigations, particularly in children, ultrasound and superb microvascular imaging (SMI) may offer alternative methods of evaluating new bone formation when limb lengthening is undertaken in paediatric patients. The aim of this study was to assess the use of ultrasound combined with SMI in monitoring new bone formation during limb lengthening in children.
UNASSIGNED: In this retrospective cohort study, ultrasound and radiograph examinations were performed every two weeks in 30 paediatric patients undergoing limb lengthening. Ultrasound was used to monitor new bone formation. The number of vertical vessels and the blood flow resistance index were compared with those from plain radiographs.
UNASSIGNED: We categorized the new bone formation into three stages: stage I (early lengthening), in which there was no obvious callus formation on radiographs and ultrasound; stage II (lengthening), in which radiographs showed low-density callus formation with uneven distribution and three sub-stages could be identified on ultrasound: in Ia punctate callus was visible; in IIb there was linear callus formation which was not yet connected and in IIc there was continuous linear callus. In stage III (healing), the bone ends had united, the periosteum was intact, and the callus had disappeared, as confirmed on radiographs, indicating healed bone. A progressive increase in the number of vertical vessels was noted in the early stages, peaking during stages IIb and IIc, followed by a gradual decline (p < 0.001). Delayed healing involved patients with a prolonged stage IIa or those who regressed to stage IIa from stages IIb or IIc during lengthening.
UNASSIGNED: We found that the formation of new bone in paediatric patients undergoing limb lengthening could be reliably evaluated using ultrasound when combined with the radiological findings. This combination enabled an improved assessment of the prognosis, and adjustments to the lengthening protocol. While SMI offered additional insights into angiogenesis within the new bone, its role primarily contributed to the understanding of the microvascular environment rather than directly informing adjustments of treatment.
UNASSIGNED: In this retrospective cohort study, ultrasound and radiograph examinations were performed every two weeks in 30 paediatric patients undergoing limb lengthening. Ultrasound was used to monitor new bone formation. The number of vertical vessels and the blood flow resistance index were compared with those from plain radiographs.
UNASSIGNED: We categorized the new bone formation into three stages: stage I (early lengthening), in which there was no obvious callus formation on radiographs and ultrasound; stage II (lengthening), in which radiographs showed low-density callus formation with uneven distribution and three sub-stages could be identified on ultrasound: in Ia punctate callus was visible; in IIb there was linear callus formation which was not yet connected and in IIc there was continuous linear callus. In stage III (healing), the bone ends had united, the periosteum was intact, and the callus had disappeared, as confirmed on radiographs, indicating healed bone. A progressive increase in the number of vertical vessels was noted in the early stages, peaking during stages IIb and IIc, followed by a gradual decline (p < 0.001). Delayed healing involved patients with a prolonged stage IIa or those who regressed to stage IIa from stages IIb or IIc during lengthening.
UNASSIGNED: We found that the formation of new bone in paediatric patients undergoing limb lengthening could be reliably evaluated using ultrasound when combined with the radiological findings. This combination enabled an improved assessment of the prognosis, and adjustments to the lengthening protocol. While SMI offered additional insights into angiogenesis within the new bone, its role primarily contributed to the understanding of the microvascular environment rather than directly informing adjustments of treatment.
摘要：
■鉴于可能的辐射损伤和放射调查的不准确性，特别是在儿童中，在儿科患者中进行肢体延长时，超声和出色的微血管成像（SMI）可能提供评估新骨形成的替代方法。这项研究的目的是评估超声联合SMI在监测儿童肢体延长期间新骨形成中的应用。
■在这项回顾性队列研究中，每两周对30例接受肢体延长术的儿科患者进行超声和X光检查。超声用于监测新骨形成。将垂直血管的数量和血流阻力指数与普通X光片进行了比较。
■我们将新骨形成分为三个阶段：I期（早期延长），在X线照片和超声上没有明显的愈伤组织形成；II期（延长），其中X射线照片显示低密度愈伤组织形成，分布不均，在超声下可以识别出三个子阶段：在Ia中可见点状愈伤组织；在IIb中，有尚未连接的线性愈伤组织形成，在IIc中，有连续的线性愈伤组织。在第三阶段（治疗），骨端已经结合了，骨膜完好无损,愈伤组织消失了,正如在射线照片上所证实的，显示骨愈合。早期注意到垂直船只的数量逐渐增加，在IIb和IIc阶段达到峰值，随后逐渐下降（p<0.001）。延迟愈合涉及IIa期延长的患者或在延长期间从IIb或IIc期恢复到IIa期的患者。
■我们发现，当与放射学发现相结合时，可以使用超声可靠地评估接受肢体延长的儿科患者新骨的形成。这种组合可以改善对预后的评估，以及对延长协议的调整。虽然SMI提供了新骨骼中血管生成的额外见解，它的作用主要有助于了解微血管环境，而不是直接通知调整治疗。
■在这项回顾性队列研究中，每两周对30例接受肢体延长术的儿科患者进行超声和X光检查。超声用于监测新骨形成。将垂直血管的数量和血流阻力指数与普通X光片进行了比较。
■我们将新骨形成分为三个阶段：I期（早期延长），在X线照片和超声上没有明显的愈伤组织形成；II期（延长），其中X射线照片显示低密度愈伤组织形成，分布不均，在超声下可以识别出三个子阶段：在Ia中可见点状愈伤组织；在IIb中，有尚未连接的线性愈伤组织形成，在IIc中，有连续的线性愈伤组织。在第三阶段（治疗），骨端已经结合了，骨膜完好无损,愈伤组织消失了,正如在射线照片上所证实的，显示骨愈合。早期注意到垂直船只的数量逐渐增加，在IIb和IIc阶段达到峰值，随后逐渐下降（p<0.001）。延迟愈合涉及IIa期延长的患者或在延长期间从IIb或IIc期恢复到IIa期的患者。
■我们发现，当与放射学发现相结合时，可以使用超声可靠地评估接受肢体延长的儿科患者新骨的形成。这种组合可以改善对预后的评估，以及对延长协议的调整。虽然SMI提供了新骨骼中血管生成的额外见解，它的作用主要有助于了解微血管环境，而不是直接通知调整治疗。
