CAJ | 학술논문

目的探讨实时剪切波弹性成像(shear wave elastography,SWE)技术在爆震伤致肝损伤中的应用价值.方法制作腹部轻度、中度、重度爆震伤动物模型,于爆震前、爆震后即刻行肝及腹腔常规超声及肝SWE检查,并与爆震前、爆震后即刻丙氨酸转氨酶(alanine aminotransferase,ALT)的变化和肝病理结果对比分析.结果伤后即刻常规超声检查轻度爆震伤组肝未见明显异常声像图表现;中、重度致伤组可出现不同程度的肝包膜断裂、部分肝实质区域回声不均匀、包膜下血肿、明显的肝实质连续性中断、中断的肝实质间积液、腹腔内积液等一系列肝损伤的表现,以重度爆震伤组明显.3组爆震后即刻肝弹性值和ALT均较爆震前增大,差异有统计学意义(P＜0.05),爆震后即刻3组肝弹性值及ALT组间比较,差异均有统计学意义(P＜0.05).结论在爆震伤后,肝弹性改变与肝损伤的程度相关,弹性值越高,提示损伤越重.在常规超声显像基础上,应用SWE技术为肝爆震伤的伤情判断提供了一种新的评价手段,特别对轻度肝爆震伤的诊断具有重要价值.
목적 탐토실시전절파탄성성상(shear wave elastography,SWE)기술재폭진상치간손상중적응용개치.방법 제작복부경도、중도、중도폭진상동물모형,우폭진전、폭진후즉각행간급복강상규초성급간SWE검사,병여폭진전、폭진후즉각병안산전안매(alanine aminotransferase,ALT)적변화화간병리결과대비분석.결과 상후즉각상규초성검사경도폭진상조간미견명현이상성상도표현;중、중도치상조가출현불동정도적간포막단렬、부분간실질구역회성불균균、포막하혈종、명현적간실질련속성중단、중단적간실질간적액、복강내적액등일계렬간손상적표현,이중도폭진상조명현.3조폭진후즉각간탄성치화ALT균교폭진전증대,차이유통계학의의(P＜0.05),폭진후즉각3조간탄성치급ALT조간비교,차이균유통계학의의(P＜0.05).결론 재폭진상후,간탄성개변여간손상적정도상관,탄성치월고,제시손상월중.재상규초성현상기출상,응용SWE기술위간폭진상적상정판단제공료일충신적평개수단,특별대경도간폭진상적진단구유중요개치.
Objective To explore the application value of real-time shear wave elastography(SWE) in the liver injury caused by the blast injury.Methods The abdominal mild,moderate and severe blast injury animal models were built,liver and abdominal cavity conventional ultrasound scan and liver SWE measurement were processed before and immediately post-blast,and then the two groups' liver alanine aminotransferase (ALT) and the liver pathology results were compaired.Results The conventional ultrasound scan,immediately after the injury,had found no abnormities of the hepatic tissue in the mild blast injury group,while varying degrees of liver capsular rupture,part of the liver parenchyma regional uneven echo,subcapsular hematoma,obvious liver parenchyma interruption,effusion between the disruption of liver parenchyma and abdominal cavity effusion etc.a series of liver injury had been found in the moderate and severe groups,and the severe blast injury group was more obvious.Three groups' immediately liver elasticity and ALT of post-blast liver injury were increased compared with the pre-blast,the liver elasticity and ALT of each group pre-and post-blast comparing had statistically signifcant (P ＜0.05),and the three groups post-blast immediately liver elasticity and ALT and any two groups' comparing also had statistically significant (P ＜0.05).Conclusions After the blast injury,the changes of liver elasticity were associated with the liver injury degree,the higher elasticity values suggest the heavier damage.Based on conventional ultrasonography,SWE could provide a new evaluation method for the judgement of liver balst injury,especially in the diagnosis of mild liver blast injury.