超声造影评价急性实验性睾丸挫伤的血流灌注

Contrast-enhanced ultrasonography for detecting testicular perfusion in acute testis contusion in rabbits

目的:探讨超声造影在急性实验性睾丸挫伤时的血流灌注表现。方法:健康新西兰雄性家兔11只,用3.0%的戊巴比妥钠耳缘静脉麻醉,剂量1.0 ml/kg。麻醉后随机打击一侧阴囊,建立睾丸挫伤模型。分别于造模前、造模后即刻、造模后2、4、6 h行彩色多普勒及超声造影检查双侧睾丸,分析造模后健侧与伤侧睾丸的时间-强度曲线(TIC),得到造影剂显影时间(AT)、达峰时间(TTP)、峰值强度(PI)、峰值降半时间(HT)、曲线下面积(AUC)。结果:超声造影在组织血流灌注上的敏感性高于彩色多普勒。造影剂在挫伤睾丸中的灌注模式为快进慢出。造模前双侧睾丸内AT、TTP及PI没有明显差异。造模后即刻、2、4、6 h伤侧睾丸与健侧相比AT(即刻:13.43±5.13vs 18.48±5.74;2 h:15.54±3.30 vs 21.15±6.28;4 h:18.24±6.63 vs 23.16±7.22;6 h:17.47±5.30 vs 18.21±8.80)、TTP(即刻:19.78±6.73 vs 26.80±8.23;2 h:24.97±2.62 vs 31.61±4.41;4 h:25.65±7.01 vs 30.31±7.26;6 h:21.87±5.15 vs27.76±8.61)明显提前(P<0.05),PI(即刻:10.17±5.99 vs 6.65±5.65;2 h:6.77±2.61 vs 4.02±1.69;4 h:7.94±4.13 vs 4.42±2.70;6 h:7.66±5.35 vs 4.16±3.44)明显增高,AUC(即刻:198.58±95.78 vs136.09±67.76;2 h:143.70±51.37 vs 98.32±44.79;4 h:145.70±98.74 vs 96.22±64.68;6h:202.54±65.72 vs 138.05±57.31)明显增大,差异均有统计学意义(P<0.05),HT(即刻:50.22±28.51 vs 54.29±28.01;2 h:41.80±7.43 vs 45.72±5.00;4 h:45.33±13.54 vs 44.81±10.81;6 h:39.67±21.64 vs 39.06±19.53)差异无统计学意义(P>0.05)。结论:超声造影可以准确定量检测急性期睾丸挫伤内血流灌注参数,对睾丸挫伤的诊断有重要参考价值。

Objective： To evaluate contrast-enhanced ultrasonography （CEUS） in detecting testicular perfusion in acute testis contusion. Methods： We established the model of testis contusion in 11 healthy male New Zealand rabbits by randomly hitting one side of the scrotum under general anesthesia. We examined the bilateral scrotums of all the animals before, immediately after and at 2, 4 and 6 hours after modeling by color Doppler flow imaging （CDFI） and CEUS, and analyzed the time-intensity curve （TIC）, arriving time （ AT）, time to peak intensity （TYP）, peak intensity （ PI）, half time of descending peak intensity （HT） and area under the curve （AUC） in the healthy and injured testis, respectively. Results ： CEUS exhibited a higher sensitivity in detecting tissue perfusion than CDFI. The mode of contrast agent perfusion in testicular contusion was fast in and slow out. There were no evident differences between the contused and the healthy testis in AT, TIP and PI before modeling. The contused testis showed significantly earlier AT and TIP,higher PI and larger AUC （P 〈 0.05 ） than the healthy one at different time points after modeling, but no statistically significant difference was found in HT （ P 〉 0. 05）. Conclusion ： Accurate parameters of testicular perfusion in acute testis contusion can be quantitatively obtained by CEUS, which are of important value for the diagnosis of testis contusion.