组织弥散弹性成像评估肝纤维化模型犬门静脉压力  

Tissue dispersion elastography for assessment of portal venous pressure in a canine liver fibrosis model

作　　者：翟林[1] 钱林学[1] 祖圆[1] 邱兰燕[1] 闫妍[1] 任晓转 

机构地区：[1]首都医科大学附属北京友谊医院超声科,100050

出　　处：《中华医学超声杂志（电子版）》2014年第12期66-70,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨组织弥散弹性成像定量分析软件评估肝纤维化模型犬门静脉压力的可行性。方法对12只成年比格(Beagle)犬背部皮下注射四氯化碳,建立肝纤维化模型。于造模前及实验第8、16、24周分别对实验犬进行实时超声弹性成像检查、测定门静脉自由压(FPP),并对模型犬行肝组织穿刺活检。通过组织弥散定量分析软件分析肝脏弹性图像,获得弹性特征参数,包括应变均值、标准差、低应变区面积百分比、复杂度、峰度、偏度、对比度、均等性、杂乱度、一致性和相关性,采用重复测量方差分析比较不同时间点各参数的差异,各参数与门静脉压力的相关性采用Pearson相关分析。结果 (1)实验犬FPP随实验进展逐渐升高,实验前及实验第8、16、24周FPP值分别为(23.01±2.08)、(33.67±3.65)、(44.17±2.17)和(51.17±4.73)cm H2O(1 cm H2O=0.098 k Pa),差异有统计学意义(F=17.688,P=0.000),实验第24周与实验前及实验第8、16周比较,差异均有统计学意义(t=5.39、4.53、4.17,P均<0.05)。(2)弹性参数中,实验前及实验第8、16、24周应变均值分别为112.78±19.21、102.56±13.24、94.35±12.97、83.37±12.70,低应变区面积百分比分别为(24.52±7.36)%、(29.64±9.88)%、(37.18±11.38)%、(44.78±12.62)%,对比度分别为107.91±35.99、116.33±26.52、127.92±25.84、143.67±38.55,各参数不同时间点比较,差异均有统计学意义(F=17.69、26.83、6.83,P均<0.05);其中低应变区面积百分比实验第24周与实验前及实验第8、16周比较,差异均有统计学意义(t=4.62,4.06,3.85,P均<0.05);其他参数多组间比较差异均无统计学意义。(3)相关分析显示低应变区面积百分比与门静脉压力呈正相关(r=0.756,P<0.001),线性回归方程为门静脉压力=0.83×低应变区面积百分比+11.575。结论实时超声弹性成像中应用组织弥散定量分析软件可作为一种无创方法定量评估肝纤维化模型犬门静脉压力。Objective To explore the feasibility of non-invasive quantitative estimation of portal venous pressure using tissue dispersion quantitative analysis software with real-time ultrasonic elastography（RTE） in canine model.Methods Twelve adult Beagles were used to establish a liver fibrosis model by subcutaneous injection of carbon tetrachloride（CCl4）.The free portal venous pressures（FPP） and RTE were measured at baseline and 8 th,16 th,and 24 th weeks after CCl4 injections on each canine and liver biopsy was done on each model canine.Characteristic parameters of elastography imaging,including average relative strain value,standard deviation of relative strain value,area ratio of low-strain region,complexity,kurtosis,skewness,contrast,entropy,inverse different moment,angular second moment and correlation were obtained using tissue dispersion quantitative software.The repeated measures analysis of variance was utilized to compare parameters at multiple points of the time in all canine.A Pearson correlation test was applied to analyze among parameters with FPP for all canine.Results（1） The values of the FPP increased gradually in 12 model canines,There were significant differences in the measurements of FPP between baseline and fibrosis canines at 8 th,16 th,24 th weeks,i.e.,（23.01±2.08） cm H2O vs（33.67±3.65） cm H2 O,（44.17±2.17） cm H2O,（51.17±4.73） cm H2 O,respectively（F=17.688,P=0.000）,24 th week comparisons of baseline and fibrosis canines at 8 th,16 th weeks were differences（t=5.39,4.53,4.17,all P〈0.05）.（2） There were significant differences of average relative strain value,area ratio of low-strain region and contrast among the elastography parameters between the baseline and fibrosis canines at 8 th,16 th,24 th weeks（F=17.69,26.83,6.83,all P〈0.05）,the data of average relative strain value was 102.56±13.24,94.35±12.97,83.37±12.70,the area ratios of low-strain region were（29.64±9.88）%,（37.18±11.38）%,（44.78±12.62）%,the contrast was 116.33±26.52

关 键 词：弹性成像技术 肝硬化 门静脉压 狗 

分 类 号：R575.2[医药卫生—消化系统] R445.1[医药卫生—内科学]