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目的探讨肾静脉结扎后肾脏不同部位超声弹性改变的规律。方法 10只日本大耳白兔,分离、结扎右肾静脉。结扎前、后15、30、60、90min时,采用剪切波超声弹性成像技术检测肾脏中部肾脏皮质、肾体及肾窦的杨氏模量平均值,各时间点各取1个肾脏进行病理学研究。结果结扎右肾静脉前,右肾皮质、肾体及肾窦杨氏模量平均值分别为(15.93±1.70)、(13.41±1.24)kPa及(11.62±0.87)kPa;结扎后15 min分别为(34.84±4.91)、(26.90±3.59)kPa及(24.73±3.95)kPa,30 min时分别为(40.07±2.95)、(30.93±3.18)kPa及(30.15±3.53)kPa,60min时分别为(50.63±2.73)、(37.37±4.04)kPa及(32.88±3.47)kPa;90min时分别为(56.61±2.96)、(41.86±3.78)kPa及(35.35±2.78)kPa。肾静脉结扎后肾脏不同部位杨氏模量平均值均显著高于结扎前(P<0.05),且随时间延长逐渐增加,差异具有统计学意义(P<0.05)。肾皮质杨氏模量平均值显著高于肾体及肾窦(P<0.05)。结论兔肾皮质杨氏模量平均值均高于肾体及肾窦,结扎兔肾静脉后90min内,肾皮质、肾体及肾窦的杨氏模量平均值均逐渐增加。本研究提示,肾脏超声弹性的研究中应注意弹性测量区的规范统一,肾静脉血流动力学状态可明显影响肾脏超声弹性测量值。
Objective To investigate the changes of ultrasonic elasticity in different parts of the kidney after renal vein ligation. Methods Ten Japanese white rabbits were isolated and ligated into the right renal vein. At 15, 30, 60, and 90 minutes after ligation, shear-wave elastography was used to detect the average Young’s modulus of the kidneys in the central cortex, kidney and sinuses. One kidney was taken at each time point for disease Theoretical study. Results The average Young’s modulus of right renal cortex, renal cortex and renal sinus were (15.93 ± 1.70), (13.41 ± 1.24) kPa and (11.62 ± 0.87) kPa, respectively, (34.84 ± 4.91), (26.90 ± 3.59) kPa and (24.73 ± 3.95) kPa respectively, and were (40.07 ± 2.95), (30.93 ± 3.18) kPa and (30.15 ± 3.53) kPa at 30 min and 50.63 ± 2.73), (37.37 ± 4.04) kPa and (32.88 ± 3.47) kPa, respectively, and were (56.61 ± 2.96), (41.86 ± 3.78) kPa and (35.35 ± 2.78) kPa at 90min respectively. The average Young’s modulus of different parts of the kidney after the renal vein ligation were significantly higher than those before the ligation (P <0.05), and gradually increased with time, the difference was statistically significant (P <0.05). The mean values of Young’s modulus in renal cortex were significantly higher than those in renal and renal sinuses (P <0.05). Conclusions The average Young’s modulus of renal cortex is higher than that of renal and renal sinus. The average Young’s modulus of renal cortex, kidney and renal sinus increases gradually within 90 minutes after ligation of rabbit renal vein. This study suggests that the study of renal ultrasound elasticity should pay attention to the standardization of elastic measurement area, renal venous hemodynamics can significantly affect the measurement of renal ultrasound elasticity.