大鼠肝泡球蚴病灶浸润增殖区微血管密度与超声造影的相关性研究  

Contrast-Enhanced Ultrasonography of Hepatic Alveolar Echinococcosis in Rats:the Correaltion of Imaging Fratures and Histologic Microvascular Density

作　　者：宋涛[1] 李海涛[2] 杨凌菲 姚兰辉[1] 温浩[2] 

机构地区：[1]新疆医科大学第一附属医院超声诊断科,乌鲁木齐830011 [2]新疆医科大学第一附属医院肝胆包虫外科、新疆包虫病临床研究所、新疆包虫病基础医学重点实验室,乌鲁木齐830011

出　　处：《中国寄生虫学与寄生虫病杂志》2014年第3期200-204,共5页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：国家自然科学基金(No.81260220)~~

摘　　要：目的研究大鼠肝泡球蚴病(HAE)模型超声造影特征性表现与微血管密度(MVD)的相关性,评价HAE周边浸润增殖区的造影增强的病理学依据。方法采用开腹直视下肝脏穿刺接种泡状棘球蚴组织混悬液的方法 (0.2 ml/只,约含原头节800个),建立泡球蚴Wistar大鼠模型30只。接种后3个月B超检查大鼠,记录病灶位置、大小、形态、边界、内部回声和血流情况等。超声造影分析病灶的增强模式和强度。处死大鼠,取病灶组织和周围肝组织制备切片,苏木素-伊红(HE)染色观察HAE病灶的组织结构;免疫组织化学染色观察HAE病灶周边浸润增殖区和周围肝组织的微血管中CD34的表达情况,显微镜下计数阳性细胞,并进行染色强度评分。分析MVD与肝泡球蚴病灶浸润增殖区超声增强的相关性。结果 B超结果显示,30只大鼠中共23只感染成功,获得HAE病灶27个;病灶最大直径为2.24 cm,平均为(0.97±0.48)cm;病灶呈圆形、类圆形或不规则形;内部回声较复杂,周边以中高回声为主,中央多呈低回声,甚至呈无回声,病灶亦可呈蜂窝状;24个病灶周边出现点状血流信号,所有病灶内部均未见明显的血流信号。超声造影结果显示,HAE病灶于超声造影动脉相早期出现周边环状增强者25个,周边环状增强内部出现蜂窝状造影剂充盈缺损区者2个;病灶增强模式表现为快速增强而缓慢消退,即"快进慢退型"。病灶HE染色结果显示,泡球蚴结构基本正常,囊泡群周边形成假结节,大量淋巴细胞形成肉芽肿。免疫组化实验结果表明,HAE病灶周边浸润区微血管呈棕褐色,其CD34阳性表达率为99.2%(118/119),其中强阳性者17.6%(21/119),中度阳性者73.1%(87/119),弱阳性者8.4%(10/119),阴性者0.8%(1/119);周围肝组织内CD34的阳性表达率为25.2%(30/119),无强阳性者,中度阳性者4.2%(5/119),弱阳性者21.0%(25/119),阴性者74.8%(89/119)。MVD与HAE病灶浸润增殖区造影增强超声图像的�Objective To correlate the characteristic images of hepatic alveolar echinococcosis （HAE） in rats using contrast-enhanced ultrasonography （CEUS） and microvascular density （MVD） in the surrounding invasion range of HAE lesions. Methods Thirty Wistar rats were infected with Echinococcus multolocularis suspension （approximately 800 protoscoleces in 0.2 ml per rat） through abdominal opening injection in liver. Three months after the inoculation, rats with hepatic E. multilocularis infection were examined by conventional and contrast-enhanced ultrasonography. The location, size, shape, boundary, inner echogenicity, and blood flow of the lesions, signal intensity and dynamic enhancement pattern were recorded. The positive rats were sacrificed and their livers were obtained. The structure of HAE lesions was observed by HE staining. Immunohistochemistry staining was performed on the infiltrative region of HAE lesion and the expression of CD34 in the surrounding hepatic parenchyma. Scoring was based on the percentage of positively stained cells and stain intensity. The correlation of MVD and the characteristic images of HAE using CEUS was analyzed. Results Twenty-three Wistar rats with hepatic E. multilocularis infection were killed, and 27 HAE lesions was found. The largest diameter of HAE lesion was 2.24 cm, and the average size was（0.97±0.48） cm. The shape of HAE lesions was round, oval, or irregular. HAE lesions presented a complex internal echo pattern. Spot-like color flow signal was observed in the tissues around the lesions, no blood flow signal was observed in HAE lesions. In 25 lesions, a circular rim-like enhancement belt was visualized at the periphery during early arterial phase, and honeycomb enhancement appeared in the other two lesions. The positive expression rate of CD34 in infiltrative zones surrounding HAE lesions was 99.2% （118/119）, with 17.6% （21/119） of strong positive, 73.1% （87/119） of moderate positive, 8.4% （10/119） of weak positive, and 0.8% （1/119�

关 键 词：超声检查 造影剂 声诺维 泡球蚴病 肝 微血管密度 

分 类 号：R532.32[医药卫生—内科学]