超声造影和增强CT对闭合性肾损伤的对比研究

目的 探讨超声造影评价不同级别的闭合性肾损伤的价值.方法 对12只实验兔建立闭合性损伤动物模型,撞击后对肾进行常规灰阶超声、超声造影及增强CT检查,依据Sargent分类诊断标准确定损伤程度,并对上述检查结果进行对照研究.结果 超声造影可清晰显示肾损伤病灶的部位、形态、范围,其显爪肾内损伤区的敏感性为100%(30/30).增强CT敏感性为83.3%(25/30),另5个肾内损伤灶未显示,超声造影显示此5个损伤灶损伤程度Ⅰ为、Ⅱ类.超声造影与增强CT对肾损伤显示的敏感性差异无统汁学意义(P>0.05),而超声造影对细小病灶的显示敏感性高于增强CT(P<0.(15).结论 超声造影可显著提高常规超声对肾损伤的诊断水平,并能有效评价肾损伤的程度,与增强CT比较其在细小病灶和活动性出血的显示方面具有一定的优势.

Compare study of contrast-enhanced ultrasonography and contrast enhanced CT in diagnosis of renal injury

Objective To analyze the value of contrast-enhanced uhrasonography(CEUS) in the diagnosis of renal injury by comparing with contrast enhanced computed tomography(CECT). Methods Blunt renal traumatic lesions were made in 12 rabbits. Conventional ultrasound,CEUS and CECT were used to detect traumatic lesions of kidneys after impacting. According to the Sargent scale, the degree of injuries was determined by CEUS,the results of which were compared with those of CECT. Results The position,morphology and range of the traumatic lesions were displayed clearly on the CEUS. The sensitivity of gray scale CEUS detecting the traumatic lesions was 100% (30/30). The sensitivity of CECT was 83.30.% (25/30). All of the five misdiagnosed lesions on CECT were clearly displayed as grade Ⅰ and Ⅱ on gray scale CEUS. The sensitivity of the two ways did not show significant difference ( P >0. 05) in detecting renal injury. The sensitivity of CEUS detecting the tiny traumatic lesions was significantly higher than that of CECT ( P<0.05). Conclusions CEUS can improve the diagnostic accuracy of ultrasound in the diagnosis of renal injury and evaluate the degree of renal injury effectively. Furthermore it is superior to CECT in detecting the tiny traumatic lesions and active hemorrhage.