闭合性肾损伤动物模型的建立及超声造影对肾损伤早期的分级诊断价值

目的 构建闭合性肾损伤动物模型并探讨超声造影(contrast-enhanced ultrasonography,CEUS)在肾损伤早期分级诊断中的应用价值.方法 采用钢球自由落体垂直撞击20只新西兰兔,36例肾脏造成不同程度的闭合性损伤,分别使用常规超声及CEUS观察肾损伤情况,并与病理分级对照分析.结果 CEUS肾损伤分级与病理分级的符合率明显高于常规超声(P＜0.05),且CEUS肾损伤分级与病理分级具有很好的一致性(Kappa=0.841,P＜0.001).结论本实验动物模型具有撞击设备操作简便、物理参数易控制、撞击部位准确及可重复性好等优点,肾损伤的病理类型、伤情特点与临床较为接近.CEUS能清晰地显示肾损伤的部位、范围及程度,可提高超声诊断肾损伤及判断损伤程度的敏感性.

Establishment of Experimental Animal Models of Blunt Renal Injury and Application Value of Contrast-enhanced Ultra sonography in Early Grading Diagnosis of Renal Injury

Objective To study the establishment of experimental animal models of blunt renal injury and application value of contrast-enhanced ultrasonography(CEUS) in early grading diagnosis of renal injury.Methods The blunt renal injuries in 36 kidneys of 20 New Zealand rabbits were caused by steel balls falling down to the renal regions.Conventional ultrosonography and CEUS were used to examine the damaged kidneys and the results were compared with pathological findings.Results The coincidence rate between CEUS and pathology was significantly higher than that between conventional ultrasonography and pathology(P<0.05).The agreement Kappa was 0.841(P<0.001).The agreement between CEUS and pathology was very good.Conclusion The animal model of blunt renal injury is simple in operation and has good repeatability.The impact location is accurate.The pathological types and damage characteristics of the animal models are similar to that of clinical patients.CEUS could clearly demonstrate the site,range and degree of damage so as to improve the sensibility of ultrasonography in diagnosis of renal injury.