超声造影联合声辐射力脉冲弹性成像评估微波消融治疗大鼠肝泡型棘球蚴病

Contrast-enhanced ultrasound and acoustic radiation force impulse elastography in evaluating efficacy of microwave ablation on hepatic alveolar echinococcosis in rats

目的观察超声造影(CEUS)联合声辐射力脉冲(ARFI)弹性成像技术评价微波消融(MWA)治疗大鼠肝泡型棘球蚴病(HAE)效果的价值。方法将40只HAE大鼠模型分为实验组(n=30)和对照组(n=10)。实验组予超声引导下MWA,对照组仅常规饲养。术前及术后1个月采用二维超声、CEUS和ARFI测量2组病灶最大径,以及实验组病灶边缘带平均灰阶比值与剪切波速度(SWV)。完成检测后处死大鼠,对组织切片行常规HE染色、CD34免疫组织化学染色及Masson染色,计数病灶边缘带微血管密度(MVD)及纤维化面积。结果术后1个月,3种方法所测实验组病灶最大径均较术前缩小(P均<0.001),对照组病灶最大径均较入组时增大(P均<0.001);CEUS、ARFI所测病灶最大径均大于二维超声(P均<0.05),CEUS与ARFI组间差异无统计学意义(P均>0.05)。术后1个月实验组病灶边缘带平均灰阶比值低于术前,平均SWV高于术前(P均<0.001);病灶边缘带MVD低于而纤维化面积高于对照组(P均<0.001),MVD与病灶边缘带灰阶比值呈正相关(r=0.541,P=0.011),SWV与纤维化面积呈正相关(r=0.494,P=0.023)。结论CEUS联合ARFI对评估MWA治疗大鼠HAE效果具有一定应用价值。

Objective To observe the value of contrast-enhanced ultrasound(CEUS)and acoustic radiation force impulse(ARFI)elastography in evaluating efficacy of microwave ablation(MWA)on hepatic alveolar echinococcosis in rats.Methods Totally 40 HAE rat models were divided into experimental group(n=30)and control group(n=10).Rats in experimental group underwent ultrasound-guided MWA,while those in control group received routine feeding.Routine 2D ultrasound,CEUS and ARFI were used to measure the maximum diameter of lesions before and 1 month later.The changes of mean gray scale ratio and shear wave velocity(SWV)in marginal zone of lesions in experimental group were compared with pathologic findings.Then the rats were all scarified,and routine HE staining,CD34 immunohistochemical staining and Masson staining were performed to count the microvessel density(MVD)and fibrosis area at the edge of lesions.Results There were 19 rats(21 lesions)in experimental group and 10 rats(10 lesions)in control group.One month after MWA,the maximum diameter of lesions obtained with 2D ultrasound,CEUS and ARFI became smaller in experimental group(all P<0.001)but larger than before in control group(all P<0.001).The diameters of lesions obtained with CEUS and ARFI were larger than with 2D ultrasound in both groups(all P<0.05),while there was no significant difference between CEUS and ARFI(all P>0.05).One month after MWA,the mean gray scale ratio of ablation edge in experimental group was lower,while SWV value was higher than that before(both P<0.001).MVD of the ablation edge in experimental group was lower than that in control group(P<0.001),and the fibrosis area of experimental group was higher than that of control group(P<0.001).MVD was positively correlated with the gray scale ratio at the ablation edge(r=0.541,P=0.011),and SWV was positively correlated with the fibrosis area of Masson(r=0.494,P=0.023).Conclusion Both CEUS and ARFI had certain application value for evaluation on efficacy of microwave ablation for treatment of HAE in rat models.