超声造影定量分析早期诊断急性放射性肝损伤的实验研究

摘要

目的 探讨超声造影对急性放射性肝损伤早期诊断的应用价值.方法 60只雌性大鼠,取50只建立大鼠放射性肝损伤模型,给予立体定向单次剂量20 Gy X线照射,于3、7、14、21、28 d随机从造模大鼠中取10只,从对照大鼠中取2只行超声造影检查及肝标本病理组织学检查.以病理标准进行分组:正常对照组、轻度肝损伤组、中度肝损伤组及重度肝损伤组.对4组超声造影图像行脱机分析,记录各组造影剂到达肝动脉时间、造影剂到达肝静脉时间,计算肝动-静脉渡越时间,使用定量分析软件获取肝实质时间-强度曲线,记录达峰值时间、峰值强度.结果 随放射性肝损伤程度增加,峰值强度递减,达峰时间延长,肝损伤组与对照组比较,差异均具有统计学意义(P＜0.05);肝动-静脉渡越时间逐渐缩短,中、重度肝损伤组与对照组比较,差异具有统计学意义(P＜0.05).结论 超声造影定量分析对急性放射性肝损害的早期诊断具有一定价值.%Objective To evaluate early diagnostic value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in acute radiation-induced liver injury.Methods Sixty female rats were divided into two groups:50 rats in an experimental group (model group) and 10 rats in a negative control group.The rats in model group were radiated with stereotactic single dose of 20Gy on their liver to establish acute radiationinduced liver injury models.Each 10 rats from model groups and 2 rats from control group were randomly selected and underwent CEUS and histopathological examination on the 3,7,14,21,28 days after radiation.The degree of injury was classified into four groups according to pathological grading:non-injured group,mild injured group,moderated injured group and severe injured group.The dynamic images of CEUS were off-line analysis and the parameters of arrival time of contrast agent to hepatic artery (HAAT),the arrival time of contrast agent to hepatic vein (HVAT),and the transit time of hepatic artery-hepatic vein (HAHVTT) were recorded.Time intensity curve (TIC) of liver parenchyma drawn by the software of quantitative analysis was used to obtain quantitative parameters including time to peak (TTP) and peak intensity (PI).Results Along with the severity degree of radiation-induced liver injury,the quantitative parameters,PI decreased while TTP extended.PI of mild injured group,moderated injured group and severe injured group were lower than that of non-injured group (P ＜0.05).TTP of the three liver injuried groups was higher than non-injured group (P ＜0.05).The quantitative parameters HA-HVTT of moderated injured group and severe injured group were decreased than the non-injured group (P ＜0.05),whereas the difference between mild injured group and non-injured group was not significant.Conclusions Quantitative analysis of CEUS can provide a certain value for early diagnosis in acute radiation-induced liver injury.