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目的:建立一种阴囊急性闭合性损伤动物模型的实验方法,并利用常规超声和超声造影技术评价该损伤类型。方法:健康新西兰雄性大白兔21只,随机选择一侧阴囊,用0.5 kg铁球从30 cm处自由落体打击被选一侧阴囊,打击次数3~12次。利用常规超声及超声造影技术评价实验动物造模结果,并用病理结果分析验证该技术评价的准确性。结果:21例阴囊损伤造模均成功,其中挫伤10例、血肿6例、破裂5例,所有类型均经病理结果证实。常规超声能观察睾丸形态、回声改变及血流状态,但对6 h以上睾丸挫伤诊断率较低,对复杂损伤不能进行准确甄别。超声造影在挫伤组表现为造影剂快速进入,各时间点造影参数到达时间(AT)、达峰时间(TTP)与健侧比较均有统计学意义(P均<0.05),但峰值减半时间(HT)无统计学差异(P>0.05);血肿组造影能清楚勾勒出血肿的轮廓,血肿周围形成延迟低增强带,造影参数AT、TTP与健侧比较均有统计学意义;严重的睾丸破裂可以观察到睾丸内无造影剂充盈,偶可发现造影剂外溢现象。结论:铁球作多次自由落体运动打击大白兔阴囊可以建立阴囊闭合性损伤模型,<6次的打击造成单纯挫伤型损伤的可能性较大,>10次的打击多造成复杂多样的损伤。联合使用常规超声及超声造影技术可以提高对损伤类型的判断。
OBJECTIVE: To establish an experimental model of acute scrotal closure injury in animal models and to evaluate the type of injury using conventional ultrasound and contrast-enhanced ultrasound techniques. METHODS: Twenty-one male New Zealand white rabbits were randomly selected to receive a scrotum on one side. A ball of 30 kg at 0.5 cm was used to strike the selected scrotum. The number of strikes was 3 to 12 times. Conventional ultrasound and contrast-enhanced ultrasound were used to evaluate the modeling results of experimental animals. The accuracy of this technique was verified by pathological results. Results: 21 cases of scrotum injury were successfully established, including contusion in 10 cases, hematoma in 6 cases, rupture in 5 cases, all types were confirmed by pathological results. Conventional ultrasound can observe the testicular morphology, echo changes and blood flow status, but less than 6 h diagnostic rate of contusion of the testes, complex lesions can not be accurately screened. Contrast enhanced ultrasound (CEUS) showed rapid contrast in contusion group. At each time point, time of arrival (AT), time to peak (TTP) and contralateral side were all statistically significant (all P <0.05) (HT> 0.05). The contour of hematoma can be clearly outlined in the hematoma group and the delayed enhancement band around the hematoma. The parameters AT, TTP and contralateral side of the hematoma are statistically significant. Severe testicles Rupture can be observed in the testis without contrast filling, and even found that contrast agent spillover phenomenon. CONCLUSIONS: Multiple free-fall movements of iron ball against the scrotum of rabbits can establish a scrotum closure injury model. <6 shots are more likely to cause simple contusion injury. More than 10 strikes result in complicated and diverse injuries. Joint use of conventional ultrasound and contrast-enhanced ultrasound can improve the judgment of the type of injury.