灰阶超声造影评价大鼠急性锐器肝损伤的实验研究

目的：评价灰阶超声造影对急性锐器肝外伤诊断的应用价值。方法：在20只大鼠肝内共建立锐器肝外伤模型40处，分别应用常规超声及超声造影观察肝损伤的部位及损伤程度，并与病理学检查进行对照分析。结果：超声造影可清晰显示肝内损伤的部位及血肿范围，27处损伤区血肿形成无活动性出血，超声造影表现为在肝动脉期、门静脉期和延迟期均无增强，损伤区血肿与周围正常肝实质分界清晰。8处损伤区有活动性出血造影后表现为门脉相微气泡自肝内损伤血管处向血肿区呈“涌泉状”移动。超声造影显示肝内损伤区的敏感性为87．5％（35／40），显著优于常规超声20％（8／40）（P：0．000）。结论：灰阶超声造影可显著提高超声对实验大鼠急性锐器肝损伤的诊断水平，在临床上有应用价值。

Gray-scale contrast-enhanced ultrasonography in diagnosis of acute piercing hepatic trauma of rats

Objective To evaluate the value of gray-scale contrast-enhanced ultrasonography (CEUS) in diagnosis of acute piercing hepatic trauma of rats. Methods Forty piercing hepatic traumas were induced in 20 rats. Conventional ultrasonography and CEUS were performed to detect the position and degree of the traumatic lesions. The results of CEUS were compared with pathologic findings. Results Forty traumatic lesions were created successfully at different position in the rat`s livers. CEUS can clearly display the position and haematoma extent of hepatic traumas. Inactive haematoma in 27 hepatic lesions were demonstrated as anechoic defects in arterial phase, portal phase and late phase of CEUS. There was obvious demarcation between haematoma and normal liver parenchyma. And the microbubbles could be seen to flow from the ruptures to the areas of blood accumulation in 8 traumatic lesions with active bleeding through CEUS. The sensitivity of CEUS in detecting the traumatic lesion (87.5%,35/40) was significantly higher than that of conventional ultrasonography (20%,8/40) (P=0.000). Conclusion Gray-scale CEUS could remarkably improve the diagnostic level of conventional ultrasound and has clinical value in diagnosing hepatic trauma.