CEUS评价大鼠肝泡状棘球蚴病灶血流灌注的动态演变

CEUS in dynamicly assessing blood perfusion of hepatic alveolar echinococcosis in rats

目的探讨CEUS评价不同时期大鼠肝泡状棘球蚴病(HAE)血流灌注的价值。方法采用CEUS观察70只成功感染HAE的大鼠在接种后不同时期(9、28、50周)的血流灌注特征,并与病理结果对照。结果接种9周时55个(55/70,78.57%)病灶表现为高回声,15个(15/70,21.43%)病灶表现为混合性回声,病理表现为乳白色单/多囊泡样结构。随接种时间的延长(28、50周),病灶最大径逐渐增大,病灶内部实性成分及钙化灶逐渐增多,部分病灶可出现液化坏死。镜下病灶周边纤维组织逐渐增厚,周边见微血管聚集区。接种9周时CEUS显示病灶呈环状强化及分隔样强化,28周及50周时呈环状强化或伴细线样强化及无强化。CEUS后病灶边缘增强带最大宽度与病灶最大径比值随接种时间延长而逐渐减小(P=0.02)。结论接种后不同时期大鼠HAE病灶的超声征象渐趋复杂,坏死区及钙化灶增加,CEUS可显示不同时期病灶周边及内部的血流灌注特征。

Objective To evaluate the value of CEUS in dynamicly assessing the blood perfusion of hepatic alveolar echi noeoecosis （HAE） in rats. Methods The experimentally induced secondary HAE in totally 70 rats were studied at differ- ent time periods （gth week, 28th week, and 50th week） with CEUS, and compared to pathology results. Results At the 9th week, 55 HAE lesions （55/70, 78.57%） presented hyperechoic and the rest of 15 HAE lesions （15/70, 21.43%） presented mixed ecbogenicity. The single or multiple vesicular structures were found as pathological feature. At later sta ges （28th week and 50th week）, the size of lesions increased compared to 9th week with more solid structures and the calci- fications found in HAE lesions. Microscopically, the fibrous tissues surrounding the lesions gradually thickened and the mi- erovascular accumulation were visible around the lesions. The HAE lesions at the 9th week showed the ring enhancement and central septa enhancement in CEUS. The HAE lesions at the 28th week and 50th week showed combinations of no en hancement, ring enhancement, and central septa enhancement in CEUS. The ratio of edge enhancement to maximum diam- eter of lesions decreased with the progression （P=0.02）. Conclusion The ultrasonographic features in HAE lesions be come more complicated with increasing calcifications and enlarged necrosis areas with the progression. The CEUS can re- veal the dynamics of blood perfusion of HAE lesions at different stages.