超声造影对兔闭合性肝外伤诊断的实验研究

发布时间：2018-08-03 12:19

【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(P0.05)。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(P0.05)。CEUS与大体病理标本一致性较好(Kappa=0.815,P0.001)。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。
[Abstract]:Objective to evaluate the diagnostic value of contrast-enhanced (CEUS) in the diagnosis of closed liver injury in rabbits. Materials and methods Fifteen healthy New Zealand white rabbits were randomly divided into two groups: group A (n = 5) and group B (n = 5). The closed liver injury model was established in three groups of rabbits with 127.8 NV 213.0 N and 298.2 N impact force using a self-made impactor. Before and 20 min after impact, (US) and CEUS were performed to evaluate the degree of injury, and the results were compared with those of gross pathology. Results in 10 rabbits, the local hepatic capsule echo was interrupted and abnormal echo area was found in the parenchyma, which was not clear from the normal liver tissue. CEUS and time-signal intensity curve showed that the normal liver tissue was enhanced even after injection of contrast agent. No obvious enhancement was found in the lesion. The diagnostic sensitivity of US and CEUS were 66.7% (10 / 15) and 100.0% (15 / 15), respectively. The coincidence rates of US and CEUS with gross pathological specimens were 40.0% (6 / 15) and 86.7% (13 / 15), respectively. Conclusion CEUS can significantly improve the diagnosis rate of closed liver trauma, and can accurately reflect the degree of injury, which is in good agreement with the gross pathological specimen.
【作者单位】：陕西省宝鸡市中医医院超声科;广州军区广州总医院超声科;
【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)
【分类号】：R445.1;R657.3

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