灰阶超声造影在脾脏外伤诊断中的动物实验研究

Study on gray scale contrast-enhanced ultrasonography in diagnosis of splenic trauma： an animal experiment

目的评价灰阶超声造影在脾外伤诊断中的应用价值。方法在动物全麻开腹状态下建立脾脏钝性伤和锐性伤动物模型。所用动物为6只小型猪（体重30～40kg），共建立脾脏外伤模型13处，其中锐性伤5处，钝性伤8处。脾脏创伤后即刻，首先应用常规超声观察脾实质损伤的部位、范围及内部回声，然后在灰阶超声造影条件下静脉团注自制造影剂1．8ml，观察脾实质损伤的部位、范围、损伤程度及造影增强特征，并与病理组织学检查进行对照分析。结果灰阶超声造影可清晰显示脾内损伤病灶的部位、形态、范围，其显示脾内损伤区的敏感性为100％（13／13），显著优于常规超声（30．8％，P〈0.01）。脾内损伤病灶的超声造影特征为在动脉期和延迟期均无增强，呈负性显影，损伤区与周围正常实质分界清晰。在判断脾损伤的严重程度上，超声造影分级与病理学检查具有较好的一致性。结论超声造影剂结合灰阶超声造影技术可显著提高常规超声对脾脏外伤的诊断水平，在脾脏外伤的诊断上具有潜在的应用价值。

Objective To determine the value of gray scale contrast-enhanced ultrasonography in the diagnosis of splenic trauma in an animal model. Methods Thirteen splenic traumatic lesions including 8 blunt and 5 splenic piercing sharp lesions were induced in 6 pigs after the animals were anesthetized. Conventional ultrasonography and gray scale contrast enhanced ultrasonography were performed to detect the position and dimension of the traumatic lesions. The results of contrast-enhanced ultrasonography were compared with pathologic findings. Results All lesions were induced success- fully in different positions in the porcine spleen. The sensitivity of gray scale contrast-enhanced ultrasonography in detecting the traumatic lesions was significantly higher than that of the conventional ultrasonography （100% VS 37.5%, P=0. 000）. The lesions demonstrated anechoic defects in arterial, portal and late phases on contrast-enhanced ultrasonography. Pathologic examinations showed large hemorrhage region in the traumatic lesions. The splenic trauma grades evaluated by contrast-enhanced ultrasonography were in consistent with pathologic findings. Conclusions Gray scale contrast-enhanced ultrasonography can improve the accurate diagnostic ultrasound diagnosis of splenic trauma and has the potential value for clinical application.