超声造影及剪切波弹性成像评估急性放射性肝损伤:实验研究

Contrast enhanced ultrasound and shear-wave elastography for evaluation on acute radiation-induced liver injury:Experimental study

目的观察超声造影(CEUS)及剪切波弹性成像(SWE)评估兔急性放射性肝损伤(RILI)的价值。方法将20只新西兰兔随机均分为4组,分别以0、16、20及24 Gy剂量单次照射肝脏。28日后行CEUS、SWE和肝组织病理学检查,绘制时间-强度曲线(TIC),计算照射区肝组织达峰时间(TTP)、峰值强度(PI)、峰值强度减半时间(DT/2),测量照射区肝组织平均弹性模量(E_(mean))、最大弹性模量(E_(max));根据肝脏病理结果建立对照组和轻度、中度及重度损伤组,比较组间超声参数差异,评价肝损伤程度与超声参数的相关性。结果随肝损伤程度加重,照射区兔肝组织TIC TTP逐渐延长(P均<0.05)。与对照组相比,各肝损伤组PI均有不同程度降低(P均<0.05),但其间差异均无统计学意义(P均>0.05);各肝损伤组E_(mean)、E_(max)均增加,E_(mean)则随损伤程度加重而逐渐减小(P均<0.05),重度损伤组E_(max)小于轻度损伤组(P<0.05),轻、重度损伤组与中度损伤组间E_(max)差异均无统计学意义(P均>0.05)。兔肝损伤程度与TTP呈正相关(r=0.899,P<0.05),而与PI、E_(mean)、E_(max)均呈负相关(r=-0.777、-0.877、-0.586,P均<0.05)。结论CEUS及SWE可用于评估兔急性RILI。

Objective To observe the value of contrast enhanced ultrasound(CEUS)and shear-wave elastography(SWE)for evaluating acute radiation-induced liver injury(RILI)of rabbits.Methods Totally 20 New Zealand rabbits were randomly divided into 4 groups(each n=5),and the liver of rabbits were irradiated with a single dose of 0,16,20 and 24 Gy,respectively.CEUS,SWE and liver histopathology were performed 28 days later,then time-intensity curves(TIC)were drawn to calculate the peak time(TTP),the peak intensity(PI)and the half time of peak intensity descent(DT/2),also the mean elastic modulus(E_(mean))and the maximum elastic modulus(E_(max))of liver tissue in the irradiated area were measured.According to the pathological results,the control group,mild injury group,moderate injury group and severe injury group were established,and the ultrasonic parameters were compared among groups,and the correlations of the degrees of liver injury and ultrasonic parameters were evaluated.Results With the aggravation of liver injury,TTP in TIC of liver tissue in the irradiated area gradually prolonged(all P<0.05).Compared with control group,PI of all liver injury group decreased in various degrees(all P<0.05),but no significant difference of PI was found among 3 injury groups(all P>0.05).E_(mean) and E_(max) increased in all liver injury groups,while E_(mean) decreased gradually with the aggravation of liver injury(both P<0.05).E_(max) in severe injury group was significantly lower than that in mild injury group(P<0.05),but no significant difference of E_(max) was found between mild and moderate injury group(P>0.05),non between severe and moderate injury group(P>0.05).The degrees of liver injury were positively correlated with TTP(r=0.899,P<0.05)but negatively correlated with PI,E_(mean),E_(max)(r=-0.777,-0.877,-0.586,all P<0.05).Conclusion CEUS and SWE could be used to evaluate acute RILI of rabbits.