超声造影评价兔腹主动脉粥样硬化的价值

摘要

目的 探讨超声造影评价早期、进展期兔腹主动脉粥样硬化的价值及病理学基础.方法 24只日本大耳白兔随机分为3组(每组8只),正常对照组,喂正常颗粒饲料；8周动脉粥样硬化组和16周动脉粥样硬化组,喂以含1％胆固醇+2％蛋黄粉+5％猪油的混合饲料100 g后自由摄食颗粒饲料.应用氟碳白蛋白声学造影剂行腹主动脉显像,观察造影前后腹主动脉壁病变特征并进行超声分级,记录斑块检出率,与病理形态学检查结果相对照. 结果 腹主动脉超声造影后动脉内膜识别增强,内外膜界线清晰,动脉壁超声分级较造影前提高,8周动脉粥样硬化组和16周动脉粥样硬化组分别为(2.26±0.27)与(1.79±0.25)、(3.54±0.43)与(3.20±0.25),差异有统计学意义(P＜0.05)；造影显像后斑块检出率较造影前提高,8周动脉粥样硬化组为77.8％(7/9)与55.6％(5/9)、16周动脉粥样硬化组为88.2％(15/17)与70.6％(12/17),差异无统计学意义(均P＞0.05),与病理形态学检查结果相符. 结论 超声造影可改善动脉管壁和动脉粥样硬化斑块显像,提高检出早期病变及进展期斑块的准确性.%Objective To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in rabbit model of abdominal aortic atherosclerosis (AS)in early and development period.Methods Twenty-four healthy Japanese white rabbits were randomly divided into three groups:control group,hypercholesterolemic diet group for 8 weeks and 16 weeks (each for 8 rabbits).Contrast-enhanced ultrasonography for abdominal aorta was performed using sonicated perfluorocarbon albumin contrast agent.Imaging characteristics of abdominal aorta plaque of rabbits were monitored by two-dimensional mode,ultrasound visual grades were analyzed quantitatively before and after injection of contrast agent.Histopathologic changes were observed by HE staining.Results Contrast-enhanced ultrasound imaging allowed early detection of AS and showed gradual progression of atherosclerosis over time.After contrast agent injected,intimal indentification and plaques checking-out ratio were improved.The ultrasound visual grades were increased after contrast imaging in hypercholesterolemic diet group for 8 weeks [(2.26± 0.27)vs.(1.79 ±0.25)] and 16 weeks [(3.54 ±0.43) vs.(3.20 ±0.25)] (all P＜0.05).The plaque detection rate was improved after contrast-enhanced ultrasound imaging than before angiography in hypercholesterolemic diet group for 8 weeks [77.8％ (7/9) vs.55.6％ (5/9)] and 16 weeks [88.2％ (15/17) vs.70.6％ (12/17)](P ＞ 0.05).The imaging of ultrasound agreed well with pathological examination results.Conclusions Contrast-enhanced ultrasonography can effectively improve intimal and plaque imaging,and increase the detection accuracy of early and progressive pathology.