CAJ | 학술논문

目的观察肝创伤灶局部注射治疗后不同时期常规超声与超声造影表现,并与病理对照,明确局部注射止血法创伤灶的组织修复形式和相对应的超声声像图特点.方法选用NIH小鼠18只,随机分为3组,每组各6只.18只小鼠建立创伤级别相同的肝脏创伤灶,采用局部注射蛇毒凝血酶和α-氰基丙烯酸酯的方法行创伤灶局部注射止血,分别于治疗后1周、1个月、3个月行常规超声检查、超声造影检查,同时处死动物进行病理检查.结果治疗后随着时间延长,治疗区常规超声示回声强度逐渐增高,治疗后1周局部表现为不均匀低回声;治疗后1个月局部表现为不均匀中高回声,内见点状强回声;治疗后3个月可见斑片状强回声,后方伴声影.超声造影显示治疗区为低/无增强,随着时间延长,低/无增强区范围逐渐缩小.创伤区病理表现:治疗后1周表现为肝汇管区血管扩张、淤血,血管及胆管周围可见较多白细胞及淋巴细胞浸润,随时间延长,可见汇管区纤维组织增生,胆管增生并纤维化,治疗后3个月局部可见慢性淋巴细胞、浆细胞及嗜酸粒细胞,并见明显钙化形成.结论局部注射蛇毒凝血酶和α-氰基丙烯酸酯治疗肝创伤,局部表现为炎性瘢痕修复,超声回声强度与局部纤维化和钙化程度呈正相关,超声检查可作为病理改变的初步评价方法.
목적관찰간창상조국부주사치료후불동시기상규초성여초성조영표현,병여병리대조,명학국부주사지혈법창상조적조직수복형식화상대응적초성성상도특점.방법선용NIH소서18지,수궤분위3조,매조각6지.18지소서건립창상급별상동적간장창상조,채용국부주사사독응혈매화α-청기병희산지적방법행창상조국부주사지혈,분별우치료후1주、1개월、3개월행상규초성검사、초성조영검사,동시처사동물진행병리검사.결과치료후수착시간연장,치료구상규초성시회성강도축점증고,치료후1주국부표현위불균균저회성;치료후1개월국부표현위불균균중고회성,내견점상강회성;치료후3개월가견반편상강회성,후방반성영.초성조영현시치료구위저/무증강,수착시간연장,저/무증강구범위축점축소.창상구병리표현:치료후1주표현위간회관구혈관확장、어혈,혈관급담관주위가견교다백세포급림파세포침윤,수시간연장,가견회관구섬유조직증생,담관증생병섬유화,치료후3개월국부가견만성림파세포、장세포급기산립세포,병견명현개화형성.결론국부주사사독응혈매화α-청기병희산지치료간창상,국부표현위염성반흔수복,초성회성강도여국부섬유화화개화정도정정상관,초성검사가작위병리개변적초보평개방법.
Objective To obtain the tissue repair form of hepatic trauma after local injection treatment and corresponding ultrasonography and contrast-enhanced ultrasonographic ( CEUS) features, by comparative study between ultrasonography ,CEUS and pathology different stages .Methods Eighteen NIH mice were randomly divided into three groups after local injection of thrombin and α-cyanoacrylate to treat hepatic trauma.Three groups were underwent conventional ultrasonography ,CEUS and were sacrificed to get tissue pathology at 1 week,1 month,3 months after treatment,respectively.Results After treatment,the echo intensity of routine ultrasound gradually increased at the treatment area ,it was heterogeneous hypoechoic after one week;local uneven hyperechoic with punctate hyperechoic after one month , patchy hyperechoic with acoustic shadow after three months .CEUS showed injury region as low or non-enhanced area,and gradually became smaller over time.Histopathology showed vasodilatation ,congestion in hepatic portal area,white blood cells and lymphocytes around blood vessels and bile ducts after one week ,fibroplasia,bile duct hyperplasia and fibrosis could be seen in hepatic portal area over time ,after three months,lymphocytes, paddle cells, eosinophils,and calcification could be seen in injury region .Conclusion After local injection of thrombin and α-cyanoacrylate for hepatic trauma , inflammatory scar repair in trauma area, echo strength in ultrasonography is positively correlated with local fibrosis and calcification ,ultrasonography can be used as preliminary evaluation.