摘要目的 探讨超声在不同人工骨血管化中的应用价值.方法 对15只新西兰兔分别行经典双前肢桡骨大段骨缺损模型造模,左肢植入重组人骨形态发生蛋白2(rhBM P-2)珊瑚羟基磷灰石人工骨(CHA),右肢植入CHA,分别于3d、7d、11d、15d、30d及45d,对双侧CHA的4个等分点分别行常规超声及超声造影,结合时间强度曲线测量以上部位的基础强度(BI)、峰值强度(PI)、增强强度(ΔSI)、BI/PI及达峰时间(T T P),分析结果与病理进行对照.结果 相同时间内rhBM P-2组血管化程度比普通组强,前者血管化时间比后者提前,两组各 ΔSI与时间均呈显著正相关(r=0.938,0.890;P=0.000),T T P与时间均呈显著负相关(BI/PI:r=-0.798,-0.899;P=0.000;T T P:r=-0.874,-0.868,P=0.000).两种CHA四个观察点间对比,各值差异均无统计学意义,表明各观察点间血管化程度无明显差别.结论 常规超声对移植骨的结构显示清晰,超声造影能较好地显示两种CHA早期血流灌注情况,准确评估rhBMP-2应用前后CHA微血管生长的区别,二者结合有望成为临床移植骨血管化评估的新手段.

abstractsObjective To evaluate the application value of ultrasound in vascularization of different artificial bones . Methods A total of 15 New Zealand rabbits were utilized for model establishment of classic segmental bone defect in bilateral radius . Recombinant human bonemorphogenic protein-2 ( rhBMP-2 ) coralline hydroxyapatite(CHA) and CHA were implanted into left and right limbs . Each CHA was divided into 4 equal parts which were examined with conventional ultrasonography and contrast-enhanced ultrasonography( CEUS ) on 3 d ,7 d ,11 d ,15 d ,30 d and 45 d respectively . CEUS quantitative was performed by time-intensity curve(TIC) ,which parameters including the basic intensity(BI) ,peak intensity (PI) ,increased signal intensity ( ΔSI) and time to peak ( TTP) . Then the results were analyzed and compared to pathology . Results Within the same duration ,the vascularization degree in rhBMP-2 group was stronger than that in the ordinary group with advanced vascularization time . Positive correlation was detected between ΔSI and time of both groups ( r =0 .938 ,0 .890 ;P =0 .000) ,and negative correlation was found between BI/PI or TTP and time ( BI/PI: r = -0 .798 ,-0 .899 ; P = 0 .000 ;TTP= r -0 .874 ,-0 .868 ;P = 0 .000 ) . No statistical significance was observed among four observation points of both CHA ,which indicated no obvious difference in vascularization degree of each observation point . Conclusions The structure of bone graft can be clearly displayed by conventional ultrasound ,and CEUS is able to show the early blood perfusion in two CHA grafts and to accurately evaluate the difference of CHA microvascular growth before and after rhBMP-2 application . The combination of these two techniques is a promising approach of evaluating bone graft vascularization in clinical practice .