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目的分析猪肢体软组织枪伤后不同时间弹道及周围组织的MRI表现和病理学变化,为枪弹伤早期救治提供理论依据。方法将17只成年猪静脉麻醉后,取仰卧位,将右后肢悬吊固定于致伤架上,用国产95式步枪致伤,射击距离10m。于伤后2、6、12、24、48h及9、18d分别行MRI扫描和病理学检查。结果伤区组织的病理改变可分为原发弹道区、凝固性坏死区、碎裂区和变形区。凝固性坏死区宽1～3mm,在T2WI及增强T1WI上呈现“双低信号”现象;碎裂区和部分变形区呈现“双高信号”现象,但二者不能区分。结论国产95式步枪贯穿肢体软组织后伤区由内向外依次可分为原发弹道区、凝固性坏死区、碎裂区和变形区;MRI可清楚显示原发弹道和凝固性坏死区;碎裂区和变形区为围绕弹道外围的高信号区,病理组织学分界清楚。
Objective To analyze the MRI features and pathological changes of the trajectory and surrounding tissues at different time points after bullet soft tissue gunshot injury in guinea pigs and provide a theoretical basis for the early treatment of bullet wounds. Methods Thirty-seven adult pigs were anesthetized and supine. The right hindlimb was suspended and fixed on the injured frame. The wounds were injured with a Chinese-made 95-type rifle and the firing distance was 10m. At 2, 6, 12, 24, 48h and 9,18d after injury, MRI and pathology were performed. Results The histopathological changes in the injured area can be divided into primary trajectory area, coagulation necrosis area, fragmentation area and deformation area. The area of coagulation necrosis is 1 ~ 3mm wide, showing “double low signal” on T2WI and enhanced T1WI. The phenomenon of “double high signal” appears in the fragmentation area and some deformation areas, but the two can not be distinguished. CONCLUSIONS: Domestic 95-type rifles can be divided into primary trajectory area, coagulation necrosis area, fragmentation area and deformation area from inside to outside after penetrating limb soft tissue. MRI can clearly show the primary trajectory and coagulation necrosis area; The zone and the deformation zone are high signal zones around the periphery of the trajectory, and the histopathological demarcation is clear.