超声联合微泡溶解体外血栓声像图改变与病理对照研究  

Relationships Between Ultrasonic Imaging of Clots and Pathologic Changes After Ultrasound and Microbubble Thrombolysis:an in Vitro Study

作　　者：徐亚丽[1] 高云华[1] 刘政[1] 谭开彬[1] 付赤学[1] 刘平[1] 李馨[1] 

机构地区：[1]解放军第三军医大学新桥医院超声科,重庆市400037

出　　处：《中国超声医学杂志》2006年第3期164-167,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.30500478)

摘　　要：目的观察超声联合微泡对体外血栓溶栓治疗后的声像图变化,对照病理结果,探讨溶栓治疗后血栓声像图与病理改变之间的关系。方法将DiO荧光分子探针标记脂膜微泡,联合1 MHz治疗超声进行血栓溶栓治疗10 min。分组:单纯超声辐照组;单纯微泡组;超声联合微泡组。对各组溶栓治疗后血栓进行超声显像并计算溶栓率。血栓标本HE染色后光镜下观察,微泡治疗组血栓制成冷冻切片在荧光显微镜下观察。结果超声联合微泡组溶栓率(29.51±5.17)%与单纯超声组(24.13±3.93)%、单纯微泡组(21.73±2.78)%比较差异显著(P<0.01,P<0.01)。超声显示治疗前血栓呈均质弱回声团块,溶栓治疗后单纯超声组血栓呈不均质弱回声伴内部少数强光点;单纯微泡组表面可见较多强光点,内部仍呈低回声;超声联合微泡组血栓呈不均质强回声团块。光镜下单纯超声组血栓内部可见几个小裂隙,而单纯微泡组血栓内结构较均一,未见裂隙,超声联合微泡组可见血栓表面空泡和内部不规则裂隙。荧光显微镜下显示单纯微泡组血栓表面呈明亮荧光带,内部几无荧光颗粒分布,超声联合微泡组血栓表面呈更为宽大明亮荧光带,内部的荧光颗粒分布较密集。结论溶栓治疗后血栓的超声声像图改变与病理学结果关系密切。Objective To find out the relationships between the ultrasonic imaging and pathologic changes of clots after ultrasound microbubble （US-MB） thrombolysis. Methods US and lipid MB treatments were divided into 3 groups （ simple US, simple MB and US plus MB groups） to dissolve clots, and clots dissolution rates were calculated. Clots of different groups were viewed on Vivid 7 US imaging system, Pathologic examination and fluorescent microscopy were performed. Results Compared with simple US 24.13±3. 93% and simple MB 21.73± 2. 78% groups, the dissolution rate of US plus MB group 29.51 ± 5.17% was enhanced significantly （both P〈 0.01） . The echo of clots was intensified after US or （and） MB thrombolysis. There were some anomaly splits and pores in clots in US plus MB group, and a few small splits and lancinating in simple US group while none in MB group under light microscopy. Much more fluorescence particles were found in US plus MB group than that in the simple MB group. Conclusions The ultrasonic imaging of clots after different groups of US-MB thrombolysis had great correlations with their pathologic changes.

关 键 词：血栓 超声显像 微泡 溶栓治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]