超声弹性成像、超声造影技术评估门静脉压力的动物实验研究

Animal experimental study of ultrasonic elastography and contrast-enhanced ultrasonography to assess portal venous pressure

目的通过建立兔肝纤维化模型,探讨应用声脉冲辐射力弹性成像(Acoustic radiation force impulse,ARFI)技术和超声造影(Contrast-Enhanced Ultrasonography,CEUS)技术与门静脉压力的关系。方法饲养44只新西兰大白兔,随机选取8只为对照组,36只为实验组。采用皮下注射四氯化碳剂量递增法(16周,起始剂量为0.3 mL/kg,第4周剂量为0.4 mL/kg,第5周后剂量为0.5 mL/kg)建立兔肝纤维化模型,分别于造模后第4、6、8、10、12、14、16周随机选取实验组3~6只,对照组1~2只进行ARFI技术和CEUS技术检测,获取兔肝横向剪切波速度(Shear Wave Velocity,SWV)和造影参数,开腹测量兔游离门静脉压(Free Portal Pressure,FPP)。Spearman相关、Pearson相关性分析检验SWV、SWV1、HVAT、HV-HAAT与肝纤维化(Liver Fibrosis,LF)病理分期以及FPP的相关性。结果本次实验兔肝纤维化造模成功率为88.89%(32/36)。与对照组相比,各纤维化分期的SWV、SWV1、HVAT、HV-HAAT、FPP测量所得值差异均有统计学意义(P<0.05),Spearman相关分析显示SWV、SWV1、HVAT、HV-HAAT、FPP均与LF分期相关,相关系数分别为0.935、0.921、0.986、-0.842、0.940(P<0.001)。SWV、SWV1、HVAT、HV-HAAT与FPP的Pearson相关系数分别为0.857、0.947、-0.587、-0.652,均有统计学意义(P<0.001)。结论弹性成像及超声造影参数与兔门静脉压力具有较好的相关性,是评价兔门脉高压的潜在技术。

Objective To investigate the relationship between the parameters of ARFI and CEUS and portal venous pressure by the establishment of the model of liver fibrosis in rabbits.Methods A total of 44 healthy New Zealand rabbits were selected and randomly divided into 2 groups,36 for the experimental group,and 8 for control group.A rabbit model of hepatic fibrosis was established by subcutaneous injection of CCl 4(initial dose of 0.3 mL/kg,0.4 mL/kg from the 4th week,and 0.5 mL/kg from the fifth week,which was also the maintenance dose till the end of 16-week intervention).The control group were injected with normal saline.At the 4th,6th,8th,10th,12th,14th,16th week of intervention,the rabbits were randomly selected to be examined by ARFI technology in vitro and in vivo liver tissue to obtain the stiffness parameters of transverse shear wave velocity(SWV),and CEUS technology was used to obtain the hemodynamic parameters,and then measure the free portal pressure(FPP)by the laparotomy.Spearman rank correlation,Pearson correlation analysis were used to analyze the relationship between SWV,SWV1,HVAT,HV-HAAT,FPP and LF.Results The success rate of liver-fibrosis-model was 88.89%(32/36).Compared with control group,there were statistical siginificant difference of SWV,SWV1,HVAT,HV-HAAT,FPP among the different liver fibrosis stage groups(P<0.05).The relationship among SWV,SWV1,HVAT,HV-HAAT,FPP and LF were 0.935,0.921,0.986,-0.842,0.940,respectively,(P<0.001)by Spearman correlation analysis.The correlation coefficients between SWV,SWV1,HVAT,HV-HAAT and FPP were respectively 0.857,0.947,-0.587,-0.652(P<0.001 respectively).Conclusions The significant relationship between the parameters of ARFI,CEUS and FPP,which indicated ARFI,CEUS could be the potential methods for diagnosing FPP.