灰阶超声造影诊断肝外伤的动物实验研究

目的评价灰阶超声造影对肝外伤诊断的应用价值。方法在全麻开腹状态下4只小型猪肝内共建立外伤模型16处，其中锐性伤7处，钝性伤9处。肝脏创伤后分别应用常规超声及灰阶超声造影观察肝实质损伤的部位、范围、损伤程度，并与增强CT、病理学检查进行对照分析。结果灰阶超声造影可清晰显示肝内损伤病灶的部位、形态、范围，其显示肝内损伤区的敏感性为100％（16／16）．显著优于常规超声（37．5％，P=0．000）。肝内损伤病灶的超声造影特征为在肝动脉期、门静脉期和延迟期均无增强，呈负性显影，损伤区与周围正常肝实质分界清晰。在判断肝损伤的严重程度上，超声造影分级与病理学检查具有较好的一致性。结论灰阶超声造影可显著提高常规超声对肝外伤的诊断水平，在肝外伤的诊断上具有潜在的应用价值。

Study of gray scale contrast-enhanced ultrasonography in diagnosis of hepatic trauma: an animal experiment

Objective To evaluate the diagnostic value of gray scale contrast enhanced ultrasonography(CEUS) in the diagnosis of hepatic trauma.Methods Sixteen blunt and piercing hepatic trauma were induced in 4 pigs by laparotomy.The hepatic trauma included 7 piercing trauma and 9 blunt trauma.Conventional ultrasonography and CEUS were performed to detect the position and dimension of the traumatic lesion.The results of CEUS were compared with enhanced-CT and pathologic findings.Results Sixteen traumatic lesions were created successfully at different positions in the porcine livers.The sensitivity of CEUS in detecting the traumatic lesion(100%) was significantly higher than that of conventional ultrasonogaphy((37.5)%,P=(0.000)).The traumatic lesions in the liver were demonstrated as anechoic defects in arterial phase,portal phase and late phase of CEUS.The grades of hepatic trauma evaluated by CEUS were consistent well with pathologic findings.Conclusions CEUS could improve the diagnostic level of ultrasound and has potential value in diagnosing hepatic trauma.