超声造影对兔闭合性肝外伤诊断的实验研究  

Experimental Study of Contrast Enhanced Ultrasound for Evaluation of Blunt Hepatic Trauma in Rabbits

作　　者：张淑萍[1] 古旸 金兰[1] 王凤[1] 孟灵侠 李叶阔[2] 

机构地区：[1]陕西省宝鸡市中医医院超声科,陕西宝鸡721001 [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》2015年第6期405-408,共4页Chinese Journal of Medical Imaging

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

摘　　要：目的探讨超声造影(CEUS)对兔闭合性肝外伤的诊断价值,为临床闭合性肝外伤的研究提供参考。材料与方法 15只健康新西兰大耳白兔采用随机数字法分为A组、B组、C组,每组5只。使用自制撞击器分别以127.8 N、213.0 N及298.2 N撞击力对3组兔建立闭合性肝外伤模型。于撞击前、撞击后20 min内完成灰阶超声(US)及CEUS检查,评估损伤程度,并与大体病理结果进行比较。结果撞击后10只兔US示局部肝包膜回声中断,实质内见异常回声区,与正常肝组织分界不清。CEUS及时间-信号强度曲线示造影剂推注后正常肝组织均匀增强显影,病灶部位未见明显强化,与正常肝组织分界清晰。US及CEUS的诊断敏感度分别为66.7%(10/15)和100.0%(15/15),差异有统计学意义(P<0.05)。US及CEUS与大体病理标本的符合率分别为40.0%(6/15)和86.7%(13/15),差异有统计学意义(P<0.05)。CEUS与大体病理标本一致性较好(Kappa=0.815,P<0.001)。结论CEUS能显著提高闭合性肝外伤的诊断率,且可以准确反映损伤程度,与大体病理标本具有较好的一致性。Purpose To investigate the value of contrast enhanced ultrasound （CEUS） in evaluating blunt hepatic trauma and to provide experimental reference. Materials and Methods Fifteen healthy New Zealand white rabbits were randomly divided into groups A, B and C, with 5 rabbits in each group. Hepatic area of the rabbits in each group was stroked using a self-made mini striker with forces of 127.8 N, 213.0 N and 298.2 N, respectively, to establish rabbit models of blunt hepatic trauma. Gray-scale ultrasound （US） and CEUS were performed within 20 minutes before and after trauma. Results Hepatic capsular rupture was observed in 10 rabbits on US. Ill-defined hypoechoic areas in various degrees were observed. CEUS and time-signal intensity curve analysis showed that the normal hepatic tissue began to enhance after contrast agent injection, well-defined against non-enhanced hepatic lesions. The sensitivity of US and CEUS for blunt hepatic trauma were 66.7% （10/15） and 100.0% （15/15）, respectively （P〈0.05）. The agreement with specimen was 40.0% （6/15） for US and 86.7% （13/15） fbr CEUS, respectively （P〈0.05）, with Kappas0.815 for CEUS （P〈0.001）. Conclusion CEUS improves diagnostic accuracy of blunt hepatic trauma and accurately assesses the severity, which shows good agreement with gross specimen.

关 键 词：创伤 非贯通性 肝损伤 超声检查 多普勒 彩色 超声造影 造影剂 疾病模型 动物 兔 

分 类 号：R-33[医药卫生] R445.1