微血流成像联合超声造影诊断猪肾创伤伴活动性出血的实验研究

目的 探讨微血流成像（MFI）联合超声造影（CEUS）在猪肾创伤伴活动性出血诊断及定位中的应用价值。方法 选取健康巴马小型猪10只，建立肾创伤伴活动性出血模型。模型建立成功后进行CEUS及MFI检查，比较MFI联合CEUS与CEUS诊断及定位活动性出血的准确率；应用MFI联合CEUS测量活动性出血受损血管破口内径。结果 1只巴马小型猪由于麻醉原因在实验过程中意外死亡，剩余9只巴马小型猪共成功构建18处肾创伤伴活动性出血灶。CEUS与MFI联合CEUS诊断活动性出血的准确率分别为77.78%、94.44%，二者比较差异无统计学意义；CEUS与MFI联合CEUS定位活动性出血的准确率分别为55.56%、94.44%，二者比较差异有统计学意义（P<0.05）。MFI联合CEUS测得活动性出血受损血管破口内径为1.54～2.42 mm，平均（1.94±0.29）mm。结论 MFI联合CEUS能清晰显示猪肾创伤灶内受损血管，准确诊断活动性出血，且定位活动性出血的能力优于CEUS。

Micro flow imaging combined with contrast-enhanced ultrasound in the diagnosis of active bleeding from renal trauma: an experimental study

Objective To explore the application value of micro flow imaging (MFI) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis and localization of active bleeding from renal trauma. Methods The model of renal trauma with active bleeding was established in 10 healthy Bama miniature pigs. B-mode ultrasound, color Doppler flow imaging, CEUS and MFI combined with CEUS were performed successively after the model was established. The accuracy of CEUS and MFI combined with CEUS in the diagnosis and localization of active bleeding from renal trauma were compared. The inner diameter of damaged vessels in renal trauma with active bleeding was measured on MFI combined with CEUS images. Results 18 cases of renal trauma with active bleeding were successfully established in Bama miniature pigs. The accuracy of CEUS and MFI combined CEUS in the diagnosing of active bleeding was 77.78% and 94.44%, respectively, and the difference was not statistically significant (P>0.05). The accuracy of CEUS and MFI combined CEUS in the localization of active bleeding was 55.56% and 94.44%, respectively, and the difference was statistically significant (P<0.05). The inner diameter of damaged vessels in renal trauma with active bleeding on MFI combined with CEUS images was 1.54-2.42 mm. Conclusion MFI combined with CEUS can clearly display the damaged vessels of renal trauma with active bleeding, accurately diagnose active bleeding, and improve the ability to locate active bleeding, providing more diagnostic information for guiding clinical minimally invasive interventional hemostasis and prognosis evaluation.