Diagnostic Doppler Mapping of Acute Hematogenous Osteomyelitis in Children

Doppler mapping is used along with the B-mode to identify the vascularization of the periosteum in patients with suspected osteomyelitis. Objective: to estimate the information content in duplex scanning mode, color and power Doppler mapping (DSM and PDM) in diagnosing different phases of acute hematogenous osteomyelitis in children. Material and methods. The study included 23 children aged from 2 to 15 with acute hematogenous osteomyelitis who came by way of ambulance to the children's surgical hospital in Tomsk in the period 2009-2015 in the period from 1 to 14 days after the onset of clinical signs of disease. Ultrasonography (ultrasound scanner Mindray M7 with multifrequency linear transducer 9-12 MHz) was performed on5the day of receipt of all the children (n = 23; 100%) in B-mode and using color and power Doppler imaging. Results. Ultrasound picture of intramedullary phase of acute osteomyelitis was detected on 1-3 day from the onset of the disease and is a combination of hypo echogenicity of the periosteum and increased vascularization in the form of multiple loci and increased reactive vascularization of the adjacent soft tissues. Ultrasound data have the highest sensitivity for acute hematogenous osteomyelitis in extramedullary phase with subperiosteal abscess in B-mode, and in the color and power Doppler in connection with a clear visualization of the fluid, demarcated exfoliated periosteum and high vascularization of the periosteum. Osteomyelitis due to melting periosteum phlegmon, liquid accumulations adjacent to bone is accompanied by poor vascularization that color and power Doppler mapping increases the false-negative results and thus - to reduce sensitivity (87.5%) compared with the picture subperiosteal abscess (100%). Conclusion. Diagnostic significance during all phases of the osteomyelitic process can increase the information content of indicators method in comparison with the B-mode and shorten the diagnostic phase of the study.

острый гематогенный остеомиелит, ультразвуковая диагностика, допплеровское картирование, acute hematogenous osteomyelitis, ultrasound diagnostics, Doppler mapping

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