發(fā)布時(shí)間：2018-04-27 00:08

  本文選題：超聲 + 彈性成像��； 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：本研究通過(guò)探討超聲彈性成像參數(shù)與肝纖維化病理分期的關(guān)系，評(píng)估超聲彈性成像參數(shù)診斷肝纖維化程度的可行性及其病理分子生物學(xué)基礎(chǔ)。 資料與方法：實(shí)驗(yàn)分組：54只新西蘭兔皮下注射硫代乙酰胺（thioacetamide,TAA）誘導(dǎo)肝纖維化作為模型組[1~2]，經(jīng)病理組織檢查后分為S0組、S1組、S2組、S3組和S4組，另取8只新西蘭兔為正常對(duì)照組（normal,N）。實(shí)驗(yàn)兔麻醉后，肝區(qū)去毛，立位檢查，選擇劍突下肝左葉，避開肝內(nèi)大血管，距肝被膜0.5~1.0cm，深度4cm，二維取好切面，轉(zhuǎn)換至彈性成像，感興趣區(qū)(regionof interest, ROI)周長(zhǎng)46.1mm，面積1.3cm2，出現(xiàn)5個(gè)連續(xù)穩(wěn)定波谷，選取其中一個(gè)波谷形成的彈性圖，得到11個(gè)彈性特征量，重復(fù)操作3次，取平均值，通過(guò)軟件計(jì)算得出肝纖維化指數(shù)（liver fibrosis index,LF index）。處死實(shí)驗(yàn)兔，取其肝左葉組織，行HE染色、網(wǎng)染及Masson染色，根據(jù)病理檢查結(jié)果進(jìn)行分期（S0~S4期）。另取肝組織于㧟80℃液氮凍存，行western-blot檢測(cè)I型膠原（collagen I，Col I）、Ⅲ型膠原（collagen Ⅲ，Col Ⅲ）表達(dá)水平。分析LF index與肝纖維化病理分期的相關(guān)性以及肝組織ColⅠ、Col Ⅲ表達(dá)水平與肝纖維化病理分期的相關(guān)性。 結(jié)果： 1．肝纖維化病理分期：S0期7只，S1期14只，S2期6只，S3期7只，S4期5只。 2．超聲彈性特征參數(shù)隨肝纖維化病理分期加重呈增高趨勢(shì)，，其中LF index與肝纖維化病理分期的相關(guān)性最好（r=0.718、P＜0.05）。 3．N~S2組與S3~S4組相比ROC曲線下面積為0.983，LF index值為3.11時(shí)，敏感性和特異性最大，分別達(dá)到83.3%、97.1%。 4．肝組織ColⅠ、Col Ⅲ表達(dá)水平隨肝纖維化病理分期加重總體呈增高趨勢(shì)，肝組織ColⅠ、Col Ⅲ表達(dá)水平與肝纖維化病理分期呈正相關(guān)（r=0.693，P＜0.05；r=0.611，P＜0.05)。 結(jié)論：LF index隨肝纖維化病理分期呈顯著正相關(guān)，超聲彈性成像有望成為無(wú)創(chuàng)評(píng)估肝纖維化程度的新技術(shù)。
[Abstract]:Objective: to investigate the relationship between ultrasonic elastic imaging parameters and pathological stages of liver fibrosis and to evaluate the feasibility and pathological molecular biological basis of ultrasonic elastic imaging parameters in diagnosing the degree of hepatic fibrosis. Materials and methods: liver fibrosis was induced by subcutaneous injection of thioacetamide-thioacetamide (TAA) into 54 New Zealand rabbits. After pathological examination, liver fibrosis was divided into S0 group, S1 group, S2 group, S3 group and S4 group, and 8 New Zealand rabbits were taken as normal control group. After anaesthesia, the liver area was removed, the liver was examined by standing position, the hepatic Zuo Ye was selected under the xiphoid process, the large hepatic vessels were avoided, the depth was 4 cm, the two dimensional section was taken and converted to elastic imaging. The region of interest (ROI) is 46.1mm in circumference and 1.3cm ~ 2 in area. There are five continuous stable troughs. The liver fibrosis index (fibrosis) was calculated by software. The experimental rabbits were killed and the liver Zuo Ye tissues were taken for HE staining, net staining and Masson staining. According to the pathological results, stage S0 S4 was performed. The liver tissue was frozen at 80 鈩

本文編號(hào)：1808284