声脉冲辐射力成像定量评估兔肝缺血再灌注损伤实验研究

Quantitative assessment of hepatic ischemia reperfusion injury with acoustic radiation force impulse in rabbit

目的:应用声脉冲辐射力成像(ARFI)观察兔肝缺血再灌注各个时间点剪切波速度值(SWV)的变化特点,并探讨其临床应用价值。方法:60只新西兰大白兔随机分成假手术组(Sham组)及肝缺血再灌注组(IRI组),IRI组又按再灌注时间不同分成0.5、2、6、12、24、72 h共6个亚组,用无创动脉夹夹闭兔肝左叶的血供建立兔半肝IRI模型;应用ARFI测量各组肝左叶的SWV值;处死实验兔,取肝左叶组织行病理学检查,分析SWV值与病理学检查结果的相关性。结果:肝IRI非梗死组织及梗死组织的各组SWV值均较Sham组SWV升高,差异均有统计学意义(P<0.001);非梗死组织IRI 12 h组SWV值达到峰值,梗死组织IRI 24 h组SWV值达到峰值;肝IRI 6、12、24、72 h组梗死组织SWV值均较未梗死组织显著升高,差异有统计学意义(P<0.001);非梗死组织及梗死组织的SWV值与光镜组织学评分均具有显著相关性(r=0.759,P<0.01;r=0.774,P<0.01),其中6 h组梗死组织出现以后,梗死组织的SWV值与光镜组织学评分相关性较非梗死组织好(r=0.774,P<0.01;r=0.473,P<0.01)。结论:ARFI技术是评估肝IRI的一种快速、便捷、实时、较准确的方法,同时能够准确判定肝梗死区,为肝IRI的诊断及治疗提供客观依据。

Objective:To observe the dynamic changes of shear wave velocity(SWV)by acoustic radiation force impulse(ARFI)in hepatic ischemia reperfusion injury(IRI)model and investigate the clinical value.Methods:Sixty New Zealand white rabbits were randomly divided into a sham operation group(Sham group)and a liver ischemia-reperfusion group(IRI group).The IRI group was further divided into six subgroups(0.5,2,6,12,24,and 72 hours)according to the reperfusion time.In six subgroups,the rabbit liver hepatic IRI model was established by clamping the blood supply of the left lobe of the rabbit with a non-invasive arterial clip;the ARFI was used to measure the SWV value of the left lobe of each group and analyze the correlation between SWV value and pathological examination results.Results:The SWV values of non-infarcted tissues and infarcted tissues in liver IRI were higher than those in Sham group,and the differences were statistically significant(P<0.001).The SWV values of non-infarcted tissues in IRI 12h group peaked,and which of infarcted tissues in IRI 24h group reached a peak value.The SWV values of infarcted tissues of the liver IRI 6,12,24,and 72 hours groups were significantly higher than those of non-infarcted tissues,and the difference was statistically significant(P<0.001).The SWV values of non-infarcted tissues and infarcted tissues were significantly correlated with the light microscope histology scores(r=0.759,P<0.01;r=0.774,P<0.01).Among them,the correlation between the SWV value of the infarcted tissue and light microscope histology score in IRI 6h group was better than that of non-infarcted tissues(r=0.774,P<0.01;r=0.473,P<0.01).Conclusion:ARFI is a real-time,dynamic,fast,non-invasive and accurate assessment method of hepatic IRI.It can accurately determine the area of hepatic infarction and provide an objective basis for the diagnosis and treatment of hepatic IRI.