超声造影检测胆道微循环受损的实验研究  

Detection of Biliary Ischemia by Contrast-enhanced Ultrasonography

作　　者：任杰[1] 郑博文[1] 郑荣琴[1] 易述红[1] 王桥[1] 张英才[1] 

机构地区：[1]中山大学附属第三医院超声科,广州市510630

出　　处：《中国超声医学杂志》2013年第9期840-843,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助(No.30901465)

摘　　要：目的应用胆道缺血兔模型,探讨超声造影检测胆道微循环受损的可靠性及其病理基础。方法将30只新西兰兔随机分成正常组、手术组及假手术(SO)组。术后5 d进行血清学(ALT、AST、GGT、ALP、TBIL)、胆道普通超声、超声造影与病理学检查[HE染色和微血管密度(MVD)测定]。结果(1)血清学:手术组各指标均较正常组、SO组明显增高(P<0.05)。(2)普通超声:手术组胆管表现与正常组、SO组差异显著,表现为胆管扩张、管壁增厚。(3)超声造影:手术组胆管壁各时相增强水平均较其他两组明显减低(P<0.05)。(4)病理学:手术组胆管壁损伤明显,MVD显著减少(P<0.05)。结论 CEUS可通过检测胆管壁灌注过程反映胆道血供,胆管壁增强水平的减低反映了胆管微循环受损的病理改变。胆道缺血有望成为CEUS新的适用范围。Objective To explore the reliability and pathology of contrast-enhanced ultrasonography （CEUS） to detect biliary ischemia using an animal model. Methods 30 New Zealand rabbits were divided into normal group, op- eration group and sham operation （SO） group at random. The observation time point was determined as day 5 post op- eration. Serum indexes （ALT, AST, GGT, ALP and TBIL） were measured, the conventional ultrasonography and CEUS of bile duct were performed, finally the patho-morphological score and microvaseular density （MVD） were assessed. Results （1）Serum indexes levels of operation group were significantly higher compared with those of normal and SO group （all P（O. 05）. （2）The operation group showed thickened wall and dilated lumen on conventional ultra- sonography compared with the normal and SO groups. （3）The duct wall of operation group presented significant decrease of enhancement level on CEUS than other two groups （all P〈0.05）. （4）Microscopic examination demonstrated that operation group was significantly higher on the patho-morphological score and lower on MVD than that of normal and SO group （all P〈0. 001）. Conclusions The decrease of enhancement level of biliary wall by using CEUS reflects the reduction of blood supply of bile duct. The noninvasive ultrasonography shows the potential to monitor the devel opment of biliary ischemia.

关 键 词：胆管 缺血 超声造影 微血管 动物模型 

分 类 号：R445.1[医药卫生—影像医学与核医学]