CAJ | 학술논문

目的探讨超声造影（CEUS）对兔闭合性肝外伤的诊断价值，为临床闭合性肝外伤的研究提供参考。材料与方法15只健康新西兰大耳白兔采用随机数字法分为A组、B组、C组，每组5只。使用自制撞击器分别以127.8 N、213.0 N及298.2 N撞击力对3组兔建立闭合性肝外伤模型。于撞击前、撞击后20 min内完成灰阶超声（US）及CEUS检查，评估损伤程度，并与大体病理结果进行比较。结果撞击后10只兔US示局部肝包膜回声中断，实质内见异常回声区，与正常肝组织分界不清。CEUS及时间-信号强度曲线示造影剂推注后正常肝组织均匀增强显影，病灶部位未见明显强化，与正常肝组织分界清晰。US及CEUS的诊断敏感度分别为66.7%（10/15）和100.0%（15/15），差异有统计学意义（P<0.05）。US及CEUS与大体病理标本的符合率分别为40.0%（6/15）和86.7%（13/15），差异有统计学意义（P<0.05）。CEUS与大体病理标本一致性较好（Kappa=0.815，P<0.001）。结论CEUS能显著提高闭合性肝外伤的诊断率，且可以准确反映损伤程度，与大体病理标本具有较好的一致性。
목적탐토초성조영（CEUS）대토폐합성간외상적진단개치，위림상폐합성간외상적연구제공삼고。재료여방법15지건강신서란대이백토채용수궤수자법분위A조、B조、C조，매조5지。사용자제당격기분별이127.8 N、213.0 N급298.2 N당격력대3조토건립폐합성간외상모형。우당격전、당격후20 min내완성회계초성（US）급CEUS검사，평고손상정도，병여대체병리결과진행비교。결과당격후10지토US시국부간포막회성중단，실질내견이상회성구，여정상간조직분계불청。CEUS급시간-신호강도곡선시조영제추주후정상간조직균균증강현영，병조부위미견명현강화，여정상간조직분계청석。US급CEUS적진단민감도분별위66.7%（10/15）화100.0%（15/15），차이유통계학의의（P<0.05）。US급CEUS여대체병리표본적부합솔분별위40.0%（6/15）화86.7%（13/15），차이유통계학의의（P<0.05）。CEUS여대체병리표본일치성교호（Kappa=0.815，P<0.001）。결론CEUS능현저제고폐합성간외상적진단솔，차가이준학반영손상정도，여대체병리표본구유교호적일치성。
Purpose To investigate the value of contrast enhanced ultrasound (CEUS) in evaluating blunt hepatic trauma and to provide experimental reference. Materials and Methods Fifteen healthy New Zealand white rabbits were randomly divided into groups A, B and C, with 5 rabbits in each group. Hepatic area of the rabbits in each group was stroked using a self-made mini striker with forces of 127.8 N, 213.0 N and 298.2 N, respectively, to establish rabbit models of blunt hepatic trauma. Gray-scale ultrasound (US) and CEUS were performed within 20 minutes before and after trauma. Results Hepatic capsular rupture was observed in 10 rabbits on US. Ill-defined hypoechoic areas in various degrees were observed. CEUS and time-signal intensity curve analysis showed that the normal hepatic tissue began to enhance after contrast agent injection, well-defined against non-enhanced hepatic lesions. The sensitivity of US and CEUS for blunt hepatic trauma were 66.7% (10/15) and 100.0% (15/15), respectively (P<0.05). The agreement with specimen was 40.0% (6/15) for US and 86.7% (13/15) for CEUS, respectively (P<0.05), with Kappa=0.815 for CEUS (P<0.001). Conclusion CEUS improves diagnostic accuracy of blunt hepatic trauma and accurately assesses the severity, which shows good agreement with gross specimen.