ABSTRACT
Purpose To investigate the value of contrast-enhanced ultrasound (CEUS) in monitoring hepatic parenchymal perfusion quantitatively during resuscitation after hemorrhagic shock (HS).Materials and Methods Forty-five labeled rabbits were randomly divided into five groups.One group was normal control group,and the other four groups were established reversible HS modes by using modified Wiggers method.In the four model groups,one group was chosen as the shock group,and the other three groups received colloid (hydroxyethyl starch) for resuscitation.The three resuscitation groups were named as 1 h group,4 h group,24 h group according to resuscitation time.The arterial blood was collected for testing blood lactic acid (LAC) in each group.The CEUS was performed to form time-intensity curve (TIC) for quantitative analysis.At the end of the experiment,the rabbits were sacrificed and the liver tissues were examined for pathology.Results Compared with the normal control group,the arrival time (AT) and time to peak (TTP) of the shock group were significantly prolonged,and the peak intensity (PI) and area under curve (AUC) of the shock group decreased,all with significant difference (all P＜0.05);in the 1 h resuscitation group,the PI and AUC increased,and the AT decreased,all with significant difference (all P＜0.05);in the 4 h and 24 h resuscitation group,the PI and AUC increased,and the AT and TTP decreased,but all without significant difference (all P＞0.05).Compared with the shock group,the PI and AUC of the 1 h resuscitation group increased,and the AT of 1 h resuscitation group decreased,all with significant difference (all P＜0.05);all the tested parameters of the 4 h and 24 h resuscitation group were significant different (P＜0.05).Conclusion CEUS can quantitatively evaluate the changes of hepatic parenchymal perfusion during HS resuscitation,which has a certain reference for clinical treatment.
ABSTRACT
Purpose To study the value of contrast-enhanced ultrasound (CEUS) quantitative technique in evaluating the perfusion of hepatic microcirculation in acute hemorrhagic shock (HS),and to investigate the value of CEUS quantitative analysis in HS diagnosis and treatment.Materials and Methods Sixty healthy adult New Zealand white rabbits of either gender were randomly divided into three groups for establishing mild,moderate and severe HS models,respectively.Before modeling and 30 min after stable modeling,liver CEUS examination was performed,and the original images were stored.Blood test of lactic acid,liver function,and liver biopsy for pathological examination were conducted after CEUS.Finally,the arrival time (AT),time to peak (TTP),rising time (RT),peak intensity (PI) and area under the curve (AUC) were analyzed offiine.Results Compared with pre-modeling,AUC decreased in mild HS group (P＜0.05);TTP and RT were delayed,but PI and AUC decreased in moderate and severe HS groups (all P＜0.05);AT was delayed in severe HS group (P＜0.05).The differences of TTP,RT,PI and AUC between the groups of mild,moderate and severe HS were significant (P＜0.05).Compared with pre-modeling,lactic acid in three HS groups increased significantly,the liver function indexes were changed to different degrees,and the degree of liver cell pathological changes was closely related to the degree of HS.Conclusion CEUS can quantitatively evaluate the changes of hepatic microcirculation induced by HS at different degrees.