家兔VX2肿瘤子宫病灶的超声造影研究

目的探讨家兔VX2肿瘤子宫病灶的超声造影表现。方法 44只成年雌性日本大耳家兔随机分为实验组20只及对照组24只。实验组采用子宫腔及腹腔内瘤块种植法复制家兔VX2肿瘤动物模型,对可疑肿瘤组织进行超声造影增强检查及病理检查,镜下观察确诊是否为肿瘤生长的肿块,对确诊的肿瘤灶分析其超声造影时间-强度曲线;对照组对正常子宫肌层及内膜行超声造影增强检查及病理检查,镜下观察子宫肌层及内膜结构正常者对其超声造影时间-强度曲线进行分析;将实验组与对照组超声造影时间-强度曲线内增强时间、增强强度、增强斜率及消退斜率等参数进行对比分析。结果实验组成功复制家兔子宫及腹腔肿瘤模型16例,肿瘤组织生长时间13-35 d,其中肿瘤坏死较严重者2例,未纳入结果统计;另有麻醉意外死亡者2例,未见肿瘤生长者2例。14例动物模型中获得34个肿瘤灶的超声造影检查及病理检查结果,肿瘤病灶最大径为4-30 mm;肿瘤组织超声造影增强时间、增强强度、增强斜率及消退斜率分别为（3.91±1.59）s、（12.93±2.98）d B、（3.72±1.41）d B/s及（0.20±0.08）d B/s。对照组24只家兔中的44侧子宫超声造影增强检查及病理检查,超声造影增强时间、增强强度、增强斜率及消退斜率分别为（5.64±2.58）s、（12.33±4.66）d B、（2.79±1.71）d B/s及（0.19±0.07）d B/s。实验组超声造影肿瘤组织增强模式与正常子宫差异有统计学意义,增强时间短于正常子宫（t=3.613,P〈0.05）,增强斜率大于正常子宫（t=-2.611,P〈0.05）,呈现快速增强模式,而消退斜率与正常子宫比较差异无统计学意义（t=-0.686,P=0.495）。结论超声造影增强检查可发现实验动物腹腔内小至最长径为4 mm的肿瘤病灶,对早期发现子宫内膜癌腹盆腔淋巴结转移病灶及腹盆腔侵犯肿瘤病灶有指导意义。

Investigation of contrast-enhanced ultrasonography in uterine VX2 tumor of rabbits

Objective To investigate the characteristics of contrast-enhanced ultrasonography（CEUS） in uterine VX2 tumor of rabbits.Methods Forty-four adult female Japanese big ear rabbits were randomly divided into two groups,20 in experimental group and 24 in control group.The rabbit model was established by implantating VX2 tumor fragments into uterine cavity and abdominal cavity.Suspicious tumor tissue and control group underwent CEUS and pathologic examination.The ultrasonic imaging time-intensity curves were analyzed.In ultrasonic imaging time-intensity curve,the enhancement time,enhancement strength,enhancement slope and fade slope were analyzed between the experimental group and control group.Results Sixteen cases of rabbit uterus and abdominal tumor model were successfully replicated in experimental group.Tumor tissue growth time was about 13 to 35 days and two of them cases tumor had severe necrosis.There were anesthesia accidents in 2 cases and no tumor growth in 2 cases.Thirty-four tumor lesions in 14 cases of animal models underwent CEUS and pathologic examination.The size of tumor lesions was about 4 mm to 30 mm.The enhancement time,enhancement strength,enhancement slope and fade slope were（3.91±1.59） s,（12.93±2.98） d B,（3.72±1.41） d B/s and（0.20±0.08） d B/s.Forty-four sides of uterus in 24 rabbits of the control group underwent CEUS and pathologic examination.The enhancement time,enhancement strength,enhancement slope and fade slope were（5.64±2.58） s,（12.33±4.66） d B,（2.79±1.71） d B/s and（0.19±0.07） d B/s.The difference of enhancement pattern between tumor and normal uterine was statistically significant.The enhancement time of tumor was shorter than that of normal uterus（t=-2.611,P〈0.05）.The enhancement slope of tumor was greater than that of normal uterus（t=3.613,P〈0.05） and showed fast enhancement pattern,but there was no statistically significant difference in fade slope（t=-0.686,P=0.495）.Conclusions CEUS can detect 4 mm intra-abdominal small tumo