微血流成像技术对脾脏创伤诊断价值的实验研究  

Experimental study on diagnostic value of micro⁃flow imaging technology for splenic trauma

作　　者：宋文静 叶庆桂 蒋雪[1] ONG Wenjing;YE Qinggui;JIANG Xue(Department of Ultrasound,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心超声科,北京100048

出　　处：《军事医学》2023年第11期858-861,共4页Military Medical Sciences

摘　　要：目的探讨微血流成像技术(MFI)对脾脏创伤的诊断价值。方法选取15只巴马香猪建立脾脏钝性伤模型,由2名超声医师采用常规超声、MFI技术及超声造影(CEUS)对脾脏进行检查。对3种超声检查技术的诊断敏感性进行比较。结果共建立40处脾脏创伤灶,均由大体标本表现证实。医师1,用MFI、常规超声和CEUS的诊断敏感性分别为87.5%、50.0%和95.0%;医师2,用MFI、常规超声和CEUS的诊断敏感性分别为85.0%、40.0%和97.5%。3种不同超声技术诊断敏感性的差异有统计学意义(医师1χ^(2)=39.330,P<0.001;医师2χ^(2)=48.169,P<0.001)。MFI表现为损伤区域未探及明显血流信号,或散在血流信号在受伤区域向外移动。MFI的诊断敏感性与CEUS无显著差异(P>0.05),高于常规超声(P<0.05)。MFI和CEUS的观察者间一致性中等(MFI,Kappa=0.684;CEUS,Kappa=0.655),优于常规超声(Kappa=0.500)。结论MFI对脾创伤诊断价值优于常规超声,其在腹部外伤临床救治中具有重要使用价值。Objective To investigate the diagnostic value of micro⁃flow imaging(MFI)in splenic trauma.Methods Fifteen Bama miniature pigs were selected to establish splenic trauma models.Their spleens were examined using conven⁃tional ultrasound,MFI and contrast⁃enhanced ultrasound(CEUS)by two ultrasound doctors.The diagnostic sensitivities of the three ultrasound techniques were compared.Results A total of 40 splenic trauma lesions were established and confirmed by gross specimen manifestations.The diagnostic sensitivities of MFI,conventional ultrasound and CEUS calculated by the first doctor were 87.5%,50.0%and 95.0%,respectively,compared with 85.0%,40.0%and 97.5%,respectively,by the second doctor.The differences in diagnostic sensitivity between the three ultrasound techniques were statistically significant(doctor 1,χ^(2)=39.330,P<0.001;doctor 2,χ^(2)=48.169,P<0.001).MFI was characterized by no obvious blood flow signals detected in the injured area,or scattered blood flow signals moving outward in the injured area.The diagnostic sensitivity of MFI was not significantly different from that of CEUS(P>0.05)but higher than that of conventional ultrasound(P<0.05).The inter⁃observer agreement of MFI and CEUS was moderate(MFI,Kappa=0.684;CEUS,Kappa=0.655),which was superior to that of conventional ultrasound(Kappa=0.500).Conclusion MFI has advantages over conventional ultrasound in the diagnosis of splenic trauma,and is feasible in the clinical treatment of abdominal trauma.

关 键 词：微血流成像技术 超声造影 脾脏创伤 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R641[医药卫生—诊断学]