摘要
目的探讨超声造影(Contrast Enhanced Ultrasound,CEUS)在骨再生过程中骨移植材料早期血管化的应用价值,为临床骨再生不良提供早期诊断信息。方法将25只斯泼累格·多雷(Sprague Dawley,SD)级雄性大鼠,于左侧后肢近股骨头处肌间隙内植入磷酸钙骨水泥/重组人骨形态蛋白2(Calcium Phosphate Cement/recombination huaman Bone Morphogenetic Protein-2,CPC/rh BMP-2),建立大鼠肌内异位成骨模型。在术后3、7、14、21、28 d分别进行高频超声、CEUS及病理学检测。观察不同时间CPC/rh BMP-2内的血流灌注情况及骨生成情况,并与病理结果进行对照。结果 CEUS显示,术后3 d,支架外周见少许星点状造影剂灌注,随着时间的增加,造影剂逐步向中央填充,且时间-强度曲线定量分析显示,峰值强度(Peak Intensity,PI)及曲线下面积(Area Under the Curve,AUC)逐渐上升;术后14确d,PI和AUC均达到最大值,术后21、28 d造影剂的PI、AUC降低。各组间差异具有统计学意义(p<0.05),各组间达峰时间(Tine To Oeak,TTP)差异无明显统计学意义(p>0.05)。苏木精伊红(Hematoxylin-Eosin,HE)染色显示,术后3、7、14、21、28 d支架内可见不同程度的新生血管形成,术后14 d为显著,与CEUS检查相符。结论 CEUS可早期显示CPC/rh BMP-2的新生血管形成情况,为骨移植的生长评估及骨再生不良提供诊断依据。
Obj ective To study the clinical value of contrast enhanced ultrasound in evaluating the early vascularization of bone grafts during regeneration process and provide early diagnostic information for impaired bone regeneration. Methods An ectopic bone formation model was established in 25 male Sprague Dawley （SD） rats with Calcium phosphate cement/recombination human bone morphogenetic protein-2 （CPC/rhBMP-2） in the left posterior leg proximal femoral head muscle space of the rats. High frequency ultrasound, CEUS and pathological examination were performed at 3, 7, 14, 21, 28 days after operation. Blood perfusion and osteogenesis in CPC/rhBMP-2 were compared with pathological results at different time points. Results 3 days after operation, CEUS showed a small amount of stellate contrast media perfusion on the periphery of the stent. As time went on, CEUS showed that the contrast medium was filling gradually into the center, and quantitative analysis of time intensity curve showed that the peak intensity （PI） and area under the curve （AUC） gradually increased, PI and AUC reached the maximum value at 14 days after operation. Later, the PI and AUC of the contrast medium decreased at the 21 day and the 28 day after operation, the differences among the groups were statistically significant（p〈0.05）, while there was no significant difference in peak time at each time point （p〉0.05）. Pathological examination was showed as follows： different degrees of neovascularization occurred in the grafts at the 3, 7, 14, 21, 28 days after operation and the number of vascularization at the 14 days after operation was the most obvious, which were consistent with the CEUS examination. Conclusion Neovascularization of CPC/rhBMP-2 can be displayed early with the use of CEUS, which can provide a valuable diagnostic evidence for the growth assessment of transplanted bones and impaired bone regeneration.
作者
刘帮燕
金琳
夏晴
王迎春
LIU Bang-yan;JIN Lin;XIA Qing;WANG Ying-chun(Weifang Medical University, Weifang 261000, Shandong, China;Central Hospital of Jiading District, Shanghai 201800, China)
出处
《声学技术》
CSCD
北大核心
2018年第2期146-150,共5页
Technical Acoustics
基金
嘉定区科委科研项目(JDKW-2017-W14)
