超声造影诊断兔闭合性肾外伤肾动脉闭塞的价值  

Value of Contrast-enhanced Ultrasonography in Diagnosis of Renal Artery Occlusion Caused by Blunt Renal Trauma in Rabbits

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

机构地区：[1]广州军区广州总院超声科,广州市510010 [2]中国科学院深圳先进技术研究院

出　　处：《中国超声医学杂志》2013年第10期942-944,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金重大国际合作研究项目(No.61020106008);国家自然科学基金青年科学基金项目(No.30900749);全军医学科研"十二五"计划课题(No.CWS12J076);广东省科技计划项目(No.2011B080701019;No.2012B031800309)

摘　　要：目的研究超声造影诊断闭合性肾外伤肾动脉闭塞的价值。方法健康新西兰兔10只,雌雄各半。采用SMS型撞击器自肾外侧向肾门处撞击,建立闭合性肾外伤动物模型。撞击前及撞击后10 min内,分别依次完成灰阶超声、彩色多普勒(CDFI)和超声造影(CEUS)检查。撞击后3 h,采用剖腹探查和病理检查进行验证。结果 6只兔肾主动脉发生闭塞,4只段动脉发生闭塞。灰阶超声见肾包膜下可见不同程度的积液,肾实质局部回声增强。CDFI显示6只伤肾血流灌注完全消失,另4只仅见部分肾的血流灌注信息。CEUS显示6只肾全期均无增强,4只呈较大范围的楔形无增强,小部分呈高增强。以上结果经剖腹探查和病理检查证实。结论 CEUS显示整个肾实质无增强是肾主动脉闭塞的重要指标,肾实质呈较大范围的楔形无增强是段动脉闭塞的重要特征。Objective To investigate the value of contrast-enhanced ultrasonography （CEUS） in diagnosis of re nal artery occlusion caused by blunt renal trauma. Methods Ten healthy New Zealand white rabbits, five males and five females, were included. SMS impactor was used to build blunt renal trauma models by impacting the kidneys from the renal lateral towards the renal hilus. Gray-scale ultrasound, CDFI, and CEUS were performed to detect the trau- matic lesion in sequence before hurt and within ten minutes after injury. All rabbits underwent abdominal laparotomy and pathological examifiation 3 hours after impacted. Results Six cases of main renal artery occlusion and four cases of segmental renal artery occlusion were found. Gray scale ultrasound： different degrees of fluids could be seen under the renal capsule and the echo of local renal parenchyma increased gradually. CDFI： No blood signal was observed in the six kidneys and perfusion could be detected in part of the kidney in the other four cases. CEUS： No enhancement oc curred in the six cases throughout, while in the four kidneys, a large non-enhanced area in a wedge-shape was seen with enhancement in only a little part. The results of adominal laparotomies and pathological examinations supported the results above. Conclusions No enhancement of the whole renal parenchyma in CEUS is an important indicator in diagnosis of main renal artery occlusion. A large wedge-shaped non-enhanced area in the renal parenchyma suggests the presence of segmental renal artery occlusion.

关 键 词：超声造影 肾动脉闭塞 肾 外伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.9[医药卫生—诊断学]