实时三维超声造影对兔闭合性肾外伤的诊断价值  

Diagnostic Value of Real-time Three-dimensional Contrast Enhanced Ultrasonography for Closed Renal Trauma of Rabbit

作　　者：许瑞雪[1] 李叶阔[2] 王莎莎[2] 袁桂忠[2] 李婷[2] 周群芳[2] 

机构地区：[1]南方医科大学研究生学院,广东广州510515 [2]广州军区广州总医院超声科,广东广州510010

出　　处：《中国医学影像学杂志》2013年第7期490-493,496,共5页Chinese Journal of Medical Imaging

基　　金：广东省科技计划项目(2011B080701019;2012B031800309);全军医学科研"十二五"计划课题项目(CWS12J076)

摘　　要：目的探讨实时三维超声造影对兔闭合性肾外伤的诊断价值。材料与方法健康新西兰大耳白兔15只,雌雄不限,随机平均分为A、B、C组,每组5只,分别采用SMS型撞击器以77.2N、106.2N和135.1N撞击力度对实验兔左侧肾区进行撞击,建立闭合性肾外伤动物模型。于撞击前和撞击后30min内分别依次进行灰阶超声、彩色多普勒血流显像、二维超声造影、实时三维超声造影及增强CT检查。检查结束后处死兔行病理检查。结果 15只兔肾均受到损伤,撞击力度越大,损伤级别越高。灰阶超声示4只未见明显异常,11只可见不同程度的包膜下液性暗区及范围不等的肾实质异常回声区。彩色多普勒血流显像示4只兔肾血流灌注良好,1只未见彩色血流信号,10只兔肾可见损伤病灶区血流信号呈不规则缺失。二维超声造影示2只兔肾未见明显损伤,1只肾全程未见增强,12只兔肾实质内可见范围不等的无增强区。实时三维超声造影示2只兔肾未见明显损伤,1只兔肾全程未见增强,12只兔肾可实时、立体、逼真地显示肾损伤病灶的部位、范围、深度及形态。增强CT检查失败1只,伤肾未见明显损伤1只,13只肾实质内可见不同程度的充盈缺损区。结论实时三维超声造影能实时、立体、逼真地显示闭合性肾损伤的部位、范围和形态,能为临床救治提供重要的参考信息。Purpose To explore the diagnostic value of real-time three-dimensional contrast enhanced ultrasonography for closed renal trauma of rabbit. Materials and Methods Fifteen healthy New Zealand great ear white rabbits, with no sex limitation, were randomly divided into group A, B and C, with 5 rabbits in each group, left kidney area of the rabbits in each group was stroked using a SMS-based striker with percussive forces of 77.2 N, 106.2 N and 135.1 N, respectively, to build animal models of closed renal trauma. Gray-scale ultrasound, color Doppler flow imaging, two-dimensional ultrasound imaging, real-time three-dimensional contrast enhanced ultrasonography and contrast enhanced CT were executed sequentially within 30 minutes before and after the impact. Rabbits were sacrificed for pathological examination after finishing all above- mentioned examinations. Results Kidney damage occurred in all 15 rabbits, with the greater the percussive force, the higher the level of injury. Gray scale ultrasound showed no abnormality in 4 cases and different levels of visible subcapsular fluid areas and different scopes of abnormal echo areas in renal parenchyma in 11 cases. Color Doppler flow imaging showed good kidney perfusion in 4 rabbits, no color flow signal in one rabbit, and irregular blood flow signal missing lesions of the kidney in 10 rabbits. Two- dimensional ultrasound angiography showed no significant kidney damage in 2 rabbits, no renal enhancement in 1 rabbit, and different scopes of no enhancement regions in kidney parenchyma in 12 rabbits. Real-time three-dimensional contrast enhanced ultrasonography showed no significant kidney damage in 2 rabbits, no enhancement in 1 rabbit, and the scope, depth and shape of the kidney injury lesion in 12 rabbits were kidney demonstrated vividly in a real-time, three-dimensional way. Enhanced CT failed in 1 rabbit, no kidney injury was detected in 1 rabbit, and different degrees of filling defect areas in renal parenchyma were displayed in 13 rabbits. Conclusion Real-time three-

关 键 词：创伤和损伤 肾疾病 超声检查 多普勒 彩色 超声造影 体层摄影术 螺旋计算机 疾病模型 动物 兔 

分 类 号：R-33[医药卫生] R445.1