Technical and Clinical Feasibility of Contrast-enhanced Ultrasound Evaluation of Long Bone Non-infected Nonunion Healing

Overview

Journal Radiol Med

Specialty Radiology

Date 2018 May 7

PMID 29730840

Citations 6

Authors

Simona Pozza

Armanda De Marchi

Chiara Albertin

Domenico Albano

Ginevra Biino

Domenico Aloj

Luca Maria Sconfienza

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess the technical feasibility of contrast-enhanced ultrasound (CEUS) in the monitoring of non-infected long bone nonunion healing.

Methods: Twenty-five patients (16 males; mean age: 40.4 ± 11.7) with long bone nonunion were treated using surgery and mesenchymal stem cells and platelet-rich plasma. They performed CEUS up to 15 days before, 7 days, 4 and 8 weeks after treatment. To categorize the angiogenesis around the fracture site, the microvascular blood flow from CEUS was classified into four categories, depending on the portion of the investigated area that was involved in the neovascularization process: grade 0 = 0%; grade 1 = 0-30%; grade 2 = 30-70%; grade 3 = 70-100%. Nonparametric Friedman and Wilcoxon statistics were used.

Results: Before treatment, neovascularization was graded as 0 in 15/25 patients, as 1 in 10/25. Vascularity significantly increased over time (P < 0.001), namely: 1 (25th-75th percentile = 1-2) at 7 days; 2 (1-2) at 4 weeks; 3 (0-2) at 8 weeks. All patients but one showed early progressive increase in neovascularization well identified with CEUS at the fracture site.

Conclusion: CEUS is a feasible method to monitor healing in patients with long bone nonunion.

Citing Articles

Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives - A Review.

Chen S, Wang Y, Chen W, Hsiao M J Med Ultrasound. 2023; 31(2):92-100.

PMID: 37576422 PMC: 10413398. DOI: 10.4103/jmu.jmu_94_22.

Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis.

Li S, Xing F, Luo R, Liu M Front Med (Lausanne). 2022; 8:771252.

PMID: 35145974 PMC: 8822232. DOI: 10.3389/fmed.2021.771252.

Evaluation of Bone Healing Using Contrast-Enhanced Ultrasonography in Non-Operative Treatment of Tibial Fracture in a Puppy Dog.

Macri F, Angileri V, Russo T, Russo M, Tabbi M, Di Pietro S Animals (Basel). 2021; 11(2).

PMID: 33498663 PMC: 7912655. DOI: 10.3390/ani11020284.

Systematic review assessing the evidence for the use of stem cells in fracture healing.

Mott A, Mitchell A, McDaid C, Harden M, Grupping R, Dean A Bone Jt Open. 2020; 1(10):628-638.

PMID: 33215094 PMC: 7659646. DOI: 10.1302/2633-1462.110.BJO-2020-0129.

Ultrasound of iliotibial band syndrome.

Jimenez Diaz F, Gitto S, Sconfienza L, Draghi F J Ultrasound. 2020; 23(3):379-385.

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