2017 , Vol. 14 >Issue 01: 61 - 66
DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2017.01.015
深静脉血栓异质性对超声剪切波弹性影响的动物实验
收稿日期: 2016-12-19
网络出版日期: 2017-01-01
基金资助
国家自然科学基金(81141019); 海南省重点科技计划项目(ZDXM2014062); 北京市自然科学基金(7172209); 滨州医学院科研计划与科研启动基金(BY2015KJ17)
The effect of heterogeneity in different parts of deep venous thrombus on the ultrasound shear wave elasticity in rabbit
Received date: 2016-12-19
Online published: 2017-01-01
研究急慢性深静脉血栓（DVT）不同部位异质性对超声剪切波弹性测值的影响。
15只日本大耳白兔，采用单端静脉狭窄法制备下腔静脉血栓模型，分别在血栓形成后第5天（急性期）与第14天（慢性期），采用超声剪切波弹性成像技术检测血栓头、体、尾的杨氏模量值，第5天及第14天测量后各处死5只兔子，取完整下腔静脉血栓，制备成病理切片。同一部位不同时期间比较采用配对t检验，多组间比较采用单因素方差分析。
血栓形成后第5天测量15只兔子血栓头、体、尾的杨氏模量值均值分别为（5.73±0.47）kPa、（7.82±0.63）kPa、（4.76±0.45）kPa，单因素方差分析提示组间比较，差异有统计学意义（F=134.468，P<0.01），体部明显高于头部和尾部，头部显著高于尾部，差异均有统计学意义（P均<0.01）；血栓形成后第14天测量10只兔子血栓头、体、尾的杨氏模量值，平均值分别为（12.46±2.59）kPa、（15.08±2.71）kPa、（10.03±2.02）kPa，组间比较，差异有统计学意义（F=10.539，P<0.01），体部显著高于尾部，差异有统计学意义（P均<0.01），体部高于头部，差异无统计学意义（P>0.05），而头部与尾部之间比较，差异无统计学意义（P>0.05）。慢性期（14 d）血栓头、体、尾杨氏模量值均显著高于急性期（5 d），差异均有统计学意义（t=-7.456、-7.989、-8.159，P均<0.01）。病理学研究显示急慢性血栓不同部位之间、同期不同血栓之间的组织构成均存在明显异质性。
急慢性血栓不同部位之间、同期不同血栓之间的组织构成及超声剪切波弹性均存在明显异质性。采用超声弹性技术检测血栓弹性时，应考虑到血栓的异质性。观测血栓弹性评价其分期时，应选择测量血栓体部，更可靠。连续观测血栓弹性时，测量应规范，位置应统一。
刘晓娜 , 李娜 , 郑海宁 , 韩宜晓 , 叶庆桂 , 童一砂 , 温朝阳 . 深静脉血栓异质性对超声剪切波弹性影响的动物实验[J]. 中华医学超声杂志（电子版）, 2017 , 14(01) : 61 -66 . DOI: 10.3877/cma.j.issn.1672-6448.2017.01.015
To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.
Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation. Young′s modulus of the thrombus head, body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation. Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above. Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.
On the fifth day, Young′s modulus values of the thrombus head, body and tail were (5.73±0.47)kPa, (7.82±0.63)kPa and (4.76±0.45)kPa respectively. ANOVA showed significant difference among three parts (F=134.468, P<0.01). The value of the thrombus body was significantly higher than that of the head and tail (both P<0.01), and the value of the head was significantly higher than that of the tail (P<0.01). On the 14th day, Young′s modulus values of the thrombus head, body and tail were (12.46±2.59)kPa, (15.08±2.71)kPa and (10.03±2.02)kPa, respectively. ANOVA analysis also showed significant difference among three parts (F=10.539, P<0.01). The value of the thrombus body was significantly higher than that of the tail (P<0.01), and also higher than that of the head, although the difference was not significant (P>0.05). There was no significant difference between the head and tail (P>0.05). Young′s modulus values of the thrombus head, body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456, -7.989 and -8.159, respectively, all P<0.01). Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.
There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation. Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.
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