应用超声造影探索脾割裂伤伤口的实验研究

Contrast-enhanced ultrasonic evaluation of mild splenic trauma

目的:应用对比增强超声(CEUS)来探索脾割裂伤伤口的位置、范围及图像特征,为临床提供判断伤情的依据。方法:2只巴马小型猪,用手术刀经皮、经脾作深10mm、宽10mm的切口。静脉注入超声造影剂(Sono Vue)来显示伤口的位置、范围和图像特点。结果:经皮经脾形成的割裂口,于裂口的位置用二维声像图(基波和谐波模式)无法显示伤口的位置和范围。注入造影剂后,脾实质高回声消退后,呈线状强回声的割裂口显示十分清晰,此处的强回声持续时间较长。另外,紧贴裂口处的脾包膜下,可见线状强回声。脾实质内造影剂完全消除后,将造影模式转换成灰阶模式,仍可见裂口处的强回声条索,并见其后方有弱声影。再反转成彩色血流成像模式,于裂口处彩色血流明显增强。结论:由于造影剂的原因,割裂口在CEUS图上显示为强回声。因此,CEUS能反映脾损伤的程度和损伤区的部位、形态和范围。

Objective：The purpose of this study is to locate and characterize splenic trauma with contrast-enhanced ultrasound （CEUS）. Methods：A defined mild intraparenchymal lesion was done in 2pigs. Ultrasound features after trauma were observed by baseline ultrasound, color Doppler flow images （CDFI） and CEUS with a contrast agent （Sono Vue）, respectively. Results：In 2 pigs , focal intrapa-renchymal lesions on spleen with diameters ranging from 10.0 to 10.0 mm could be identified by CDFI and CEUS but not by the baseline ultrasound. Hyperechoic rift in spleen was visible along trauma area as enhancement in splenic parenchyma disappeared on CEUS. Hyperechoic line could be kept in a long time. The hyperechoic rift also appeared at the sub-capsular region beside a traumatic lesion. Hyperechoic rift in traumatic region could be seen even as CEUS was converted to conventional B-mode. Enhancement in the traumatic lesion was clearly seen in CDFI. Conclusion：Hyperechoic rift in spleen was visible along trauma area as a contrast agent is used. CEUS is useful in identifying the grade, range and location of splenic injury.