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.
出处
《中国医学影像学杂志》
CSCD
北大核心
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)
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
Wounds, nonpenetrating
Liver injury
Ultrasonography, Doppler, color
Ultrasound-guided biops
Contrast media
Disease models, animal
Rabbits
