超声造影评价闭合性肾损伤的实验研究  

Contrast-enhanced ultrasonography for evaluation of kidney injury in blunt abdominal trauma

作　　者：李叶阔[1] 周晓东[1] 张军[1] 郑敏娟[1] 杨力军[2] 刘丽文[1] 贺建国[1] 

机构地区：[1]第四军医大学西京医院超声诊断科,西安710032 [2]第四军医大学西京医院泌尿外科,西安710032

出　　处：《中华超声影像学杂志》2006年第9期709-711,共3页Chinese Journal of Ultrasonography

基　　金：军队医药卫生科研基金课题(01MB127)

摘　　要：目的探讨超声造影评价闭合性肾损伤的价值。方法20只健康杂种犬随机分为两组,每组各10只,随机选择一组进行全身肝素化处理。采用自制小型撞击器对实验犬肾区进行撞击建立动物模型。于撞击前和撞击后进行普通二维超声和超声造影检查。实验结束后处死实验动物并评估伤情,与上述结果对照研究。结果普通二维声像图:部分可见肾包膜连续性中断,包膜下可见不同程度的积液,肾实质损伤区回声强弱不等,边界不清晰。超声造影:肾损伤伴活动性出血时,不同时相实质呈现不同的增强特征,包膜破裂时可见微气泡自破裂口向肾外移动,肾集合系统严重损伤时可见微气泡自输尿管开口向膀胱“间歇喷射状”增强;肾损伤伴血肿形成时,血肿区各时相均无增强。病理结果与超声造影结果相关性好。结论超声造影能通过微气泡的增强特征实时判断闭合性肾损伤的损伤情况,及其是否存在活动性出血或形成血肿。Objective To evaluate the value of contrast-enhanced ultrasonography （CEUS） for diagnosing kidney injury in blunt abdominal trauma. Methods Twenty dogs were randomly divided into two groups and each group include ten dogs. The dogs were heparinized in one group and the other group was not heparinized. Self-made miniature impactor was used to impact these dogs to make models of blunt renal trauma. Conventional two-dimensional （2D） ultrasonography and CEUS were used to detect local echo changes of the kidneys before and after impactoring. After experiments pathologic examination was performed to evaluate the kidney injury scaling. Results The sonographic pattern of lesions in the dogs＇ kidneys at conventional 2D sonography was irregular with poorly-defined margins. The ruptures of kidneys capsules were observed in some dogs. The different degrees of blood accumulation were found under renal capsule in all cases. CEUS findings： the enhancement of injuried regions was different characteristic in different phase when kidney parenchyma damaged with active bleeding. The microbubbles flowed from the ruptures to the areas of blood accumulation just like ＂pouring spring＂or ＂spurting＂. Microbubbles were spurted periodically to the blader from debouch of ureter when its pelvis or calices was injuried. The hematoma were not enhanced in every phases. Gross pathologic findings were consistent with the CEUS results. Conclusions CEUS can judge whether active bleeding or hematomas happened in kidneys according to the enhancement characters in real time.

关 键 词：超声检查 造影剂 肾/损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]