动态增强MRI评价缺血睾丸活力演变的实验研究  

Dynamic contrast-enhanced MRI for the detection of testicular ischemia in experimental induced testicular torsion of rabbits

作　　者：任彦[1] 周云[2] 丁粤粤[3] 方林[1] 韩啸[1] 吴继志[1] 郭万亮[1] 盛茂[1] 倪勇彪[1] 周珉[1] 

机构地区：[1]苏州大学附属儿童医院影像科,215003 [2]苏州大学附属儿童医院泌尿外科,215003 [3]苏州大学附属儿童医院彩超室,215003

出　　处：《中华放射学杂志》2011年第8期775-779,共5页Chinese Journal of Radiology

基　　金：苏州大学医学部研究生创新基金资助项目（2008）

摘　　要：目的探讨MR动态增强扫描（DCE—MRI）在评价缺血睾丸活力演变中的价值。方法选取30只健康雄性新西兰大白兔，采用随机数字表法分为6组，每组5只。①组为正常对照组，②组为假手术组，③、④、⑤、⑥组分别制作左侧睾丸缺血3h、6h、12h和24h模型，分别行DCE-MRI并观察睾丸信号变化。分析双侧睾丸时间一信号强度曲线（TIC）分型，并测量30s信号强化率（SER30）、75s信号强化率（SER75）、120S信号强化率（SER120）和最大信号强化率（MSER）。组内左右睾丸SER的比较采用两个样本分布比较的Kolmogorov—Smirnov检验。结果①组与②组左右侧睾丸动态增强早期明显强化，③、④、⑤、⑥组随缺血时间延长，动态强化逐渐减低；左侧睾丸TIC①组3个为Ⅰ型，2个为Ⅱa型；②组5个均为Ⅰ型；③组2个Ⅰ型，3个为Ⅱb型；④组2个为Ⅰ型，3个为Ⅱb型；⑤组5个均为Ⅱb型；⑥组5个均为Ⅲ型。右侧睾丸除⑥组2个为Ⅱa型，其余各组均为Ⅰ型。③、④、⑤、⑥组左侧SER75的中位数分别为0．084％、0．076％、0．164％和0．065％，右侧分别为0．255％、0．410％、0．586％和0．302％，差异均有统计学意义（P值均〈0．05）。③、⑤、⑥组左侧SER120分别为0．221％、0．158％和0．059％，右侧分别为0．405％、0．522％和0．207％，差异均有统计学意义（P值均〈0．05）。③、⑤、⑥组左侧MSER分别为0．217％、0．164％和0．072％，右侧分别为0．405％、0．586％和0．302％，差异均有统计学意义（P值均〈0．05）。结论动态增强MRI能够对睾丸不全扭转做出正确判断，对于临床诊断早期不全性睾丸扭转具有潜在应用价值。Objective To evaluate the dynamic experimentally induced testicular ischemia. Methods contrast-enhanced MRI （DCE-MRI） in detecting Thirty healthy male New Zealand rabbits were randomly assigned into 6 groups. There were 5 rabbits in each of the following experimental groups ： （ 1 ） Normal control, （2） Sham-operated, （3） ischemia of 3 h group, （4） ischemia of 6 h group, （ 5 ） ischemia of 12 h group, （6） ischemia of 24 h group. In all experiment groups, the right testis served as the internal control while the left testis served as the experimental side. DCE-MRI for each animal lasts about 10 minutes. Signal enhanced ratios （SERs） of ROI for both sides of each group were calculated by a computer, and parameters of SERs of 30 s, 75 s, 120 s and maxima/SER were used for statistical analysis. Time intensity curves （TICs） were made for two sides of each group via Excel 2003 software and classified into 4 types. Statistical analysis was performed to compare the differences of SERs between left and right testis by two independent Kolmogorov-Smirnov test. Results In group 1 and 2, significant enhancement was observed on both testes of 10 rabbits. The enhancement decreased gradually with the elongation of ischemia in torsion groups. Three cases of type Ⅰ and 2 cases of type 1/ were observed in group 1, 5 cases of type Ⅰ in group two, 2 cases of type Ⅰ and 3 cases of type 11 b in group three, 2 cases of type Ⅰ and 2 cases of type Ⅱb in group four, 5 cases of type Ⅱ b in group five and 5 cases of type m in group six were noticed in the left testes. And in TICs of right testes, all cases showed TICs of type Ⅰ except 2 cases of type Ⅱ a in group six. In four torsion groups, the values for SER75 of the left side were 0. 084%, 0. 076%, 0. 164% and 0. 065%, while the right side were 0. 255%, 0. 410%, 0. 586% and 0. 302% （P 〈0. 05）. The values for SER120 in group three, five and six were 0. 221%, 0. 158% and 0. 059% for the left side, and 0. 405%, 0. 522% and 0. 207% for

关 键 词：精索扭转 磁共振成像 对比研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]