实时超声弹性成像技术在大鼠梗阻性黄疸模型定量诊断中的价值

Quantitative diagnostic value of real-time ultrasound elastography in rats with obstructive jaundice

目的探讨实时超声弹性成像技术(RTE)的弥散定量分析功能对大鼠梗阻性黄疸模型肝脏改变的定量化诊断价值。方法选取30只2.5~3.0个月龄,体质量280~330 g的雄性SD大鼠,随机分为甲组(实验组)与乙组(对照组),每组15只。甲组大鼠行手术制作可复性梗阻性黄疸动物模型,乙组大鼠仅行假手术。分别于造模前、造模后2周及解除梗阻后2周采用带有组织弥散定量分析软件的超声诊断仪对动物模型进行RTE检查,并对弹性图像进行弥散定量分析;比较分析造模前、造模后2周、解除梗阻后2周两组大鼠%AREA和MEAN值的变化情况。结果造模前及解除梗阻后2周时两组大鼠的%AREA值及MEAN值比较,差异均无统计学意义(P>0.05);甲组大鼠造模后2周%AREA及MEAN值分别为42.60±3.69、93.20±2.54,与乙组的25.40±1.40、108.00±4.93比较,差异有统计学意义(t=6.230、4.328,P=0.019、0.047);甲组大鼠造模后2周时%AREA和MEAN值分别与造模前及解除梗黄后2周比较,差异均有统计学意义(P<0.01)。结论 RTE的弥散定量分析功能可反映梗黄引起的肝脏改变,梗黄后肝脏ROI区MEAN及%AREA可有显著改变,其可作为梗阻性黄疸程度的定量化评定参考指标。

Objective To explore the quantitative diagnostic value of RTE for quantitative analysis of the elasticity of the liver changes in rats with obstructive jaundice.Methods 30 male SD rats （2.5-3.0 months,280-330 g） were randomly divided into group A （experimental group） and group B （control group）,15 rats in each group.Rats of the group A was operated to make refolding obstructive jaundice animal model,while group B was only given the sham operation.Ultrasound diagnostic imaging software was used to analyze the elasticity of the liver changes of the animal models preoperative, 2 weeks after the modeling and 2 weeks after the removal of the obstruction;and the diffusion quantitative analysis of the elastic image,the percentage of blue areas （%AREA）and strain mean （MEAN） within the region of interest （ROI） of the rat liver were measured and recorded.The changes of %AREA and MEAN in the two groups were compared at preoperative,2 weeks after the modeling and 2 weeks after the removal of the obstruction.Results There was no significant difference in %AREA and MEAN between the two groups at preoperative and 2 weeks after obstruction relieving （P〉 0.05）.The AREA and MEAN of group A were 42.60±3.69,93.20±2.54,compared with the group B of 25.40±1.40,108.00± 4.93,the difference was statistically significant （t=6.230,P=0.019;t=4.328,P=0.047）.The AREA and MEAN values at 2 weeks after modeling were compared with those at preoperative and 2 weeks after obstruction relieving,the differences were statistically significant （P〈0.05）.Conclusion Diffusion quantitative analysis of RTE can reflect the liver changes caused by obstructive jaundice,the MEAN and %AREA in the ROI of the liver after obstructive jaundice may change significantly,which can be used as quantitative indicators of the degree of obstructive jaundice reference.