灰阶超声造影评价大鼠急性钝器肝损伤的实验研究  

STUDY OF GRAY SCALE CONTRAST-ENHANCED ULTRASONOGRAPHY IN DIAGNOSIS OF ACUTE BLUNT HEPATIC TRAUMA IN RATS

作　　者：李智贤[1] 李艳宁[1] 廖新红[1] 何云[1] 张莉[1] 芦爱霞[1] 张翠红[1] 王曦曦[1] 石尖兵[1] 陈琳[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁530021

出　　处：《广西医科大学学报》2007年第3期368-370,共3页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No桂科自0339042)

摘　　要：目的:评价超声造影对急性闭合性钝器致肝损伤及活动性出血的诊断价值。方法:用20只大鼠建立钝器肝外伤模型20个,应用常规超声及超声造影观察肝损伤的部位及损伤程度,并与大鼠尸体解剖和病理学检查进行对照分析。结果:超声造影可清晰显示肝内损伤的部位及血肿范围。6处损伤区血肿形成无活动性出血,超声造影表现为在肝动脉期、门静脉期和延迟期均无增强,损伤区血肿与周围正常肝实质分界清晰。13处损伤区有活动性出血,8处超声造影表现为微气泡自肝破裂口向肝外呈"喷射状"移动;5处表现为门脉期微气泡自肝内损伤血管处向血肿区呈"涌泉状"移动。病理结果与超声造影结果基本一致。超声造影显示肝内损伤区的敏感性为95.0%(19/20),显著优于常规超声检测[35%(7/20)],(P<0.01)。结论:灰阶超声造影可实时、动态观察闭合性肝损伤的范围、程度及活动性出血的情况,对进一步的临床治疗具有重要的价值。Objective： To evaluate contrast-enhanced ultrasonography（CEUS） in diagnosis of blunt hepatic trauma with active bleeding in rats. Methods： 20 blunt hepatic traumas were induced in 20 rats. Conventional ultrasonography and CEUS were performed to detect the position and degree of the traumatic lesions. The results of CEUS were compared with pathologic findings. Result： 20 traumatic lesions were created successfully at different positions in the rats＇ livers. CEUS can clearly display the position and haematoma extent of hepatic traumas. The sensitivity of CEUS in detecting the traumatic lesion （95.0%, 19/20） was significantly higher than that of conventional ultrasonogaphy （35 %, 7/20 ; P〈0. 01）. Inactive bleeding haematoma in 6 hepatic lesions was demonstrated as anechoic defects in arterial phase, portal phase and late phase of CEUS. The radiate enhancement of vessels was interrupted in the lesion areas in arterial phase and was demonstrated with CEUS. There was obvious demarcation between haematoma and normal liver parenchyma. Gross pathologic findings were consistent with the contrast-enhanced ultrasonographic results. And then we can see the microbubbles flowed from the ruptures to the areas of blood accumulation in 13 traumatic lesions with active bleeding through CEUS. Conclusion： CEUS could help to observe blunt hepatic trauma with active bleeding in real time, which is valuable to further clinical treatment.

关 键 词：灰阶超声造影增强 肝脏 钝器损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]