目的探讨超声弹性成像评价酒精注射诱导肝脏局部坏死硬化病变的价值。方法超声引导下在新鲜猪肝局部注入无水酒精2ml诱导产生硬化坏死区。采用SONOLINE Antares超声诊断仪,VF10-5高频探头获取注射区域的声像图。同时,注射后每隔30秒,用机械挤压装置对肝组织实行定量压缩,通过系统超声研究界面采集压缩前后原始射频信号直至6min。利用互相关分析的方法,计算机处理全部原始射频信号获得组织的弹性图,并与大体标本进行对照。结果酒精注射后即刻声像图显示注射局部回声明显增强伴后方声影,随时间延长,回声增强区逐渐扩散,边界不清。反之,系列的组织弹性图显示酒精注射区组织硬度明显增加,边界清晰,硬化区范围随时间逐渐扩大,于3min达一稳定范围,与大体标本区域相似。结论超声组织弹性图能够探测并评价酒精注射后离体猪肝内的硬化坏死区。
Objective To study the value of ultrasound elastography in the evaluation of ethanol-induced lesions of liver. Methods Alcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis. Then freehand elastography of the lesion from the identical scan plane was obtained with Siemens SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later. The original high-quality radio-frequency data were acquired through an ultrasound research interface provided by the ultrasound system. Corresponding elastograms were then produced offline using cross-correlation technique and compared with gross specimen. Results A hyperechoic area with acoustic shadow below appeared immediately after alcohol injection. The hyperechoic area diffused and its boundary was illegible following injection. On the contrary, the ethanol-induced lesion in elastography appeared as a low strain hard region surrounded by high-strain soft hepatic tissues with clear but irregular boundaries. Sequential elastograms with the lesion boundaries sketched showed that the lesion area grew in the first 3 minutes after ethanol injection and then reached a plateau, which corresponded to the gross specimen. Conclusion Ultrasound elastography can be used to detect and evaluate the diffusion of ethanol-induced hepatic lesion.