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目的探讨经胆道途径超声造影研究胆管灌注的可行性。方法采用雄性日本大耳兔16只,游离肝外胆管,使用22G导管插入胆总管并固定,经此路径给药。按造影剂浓度分为4组,每组4只,分别为A组:超声造影剂为1/100标准浓度;B组:超声造影剂为1/200标准浓度;C组:超声造影剂为1/400标准浓度;D组:超声造影剂为1/800标准浓度。给药后在超声造影模式下观察微泡在肝内胆管的灌注是否完全充盈、造影信号有无外溢及造影显像满意持续时间。结果 16只大耳兔均成功制作模型,注入超声造影剂5 m L。A组肝内胆管均完全充盈,且都出现了造影信号的外溢;B组肝内胆管均完全充盈,有1例出现了造影信号的外溢。A组和B组的造影满意持续时间分别为(340±29)、(284±37)s,差异无统计学意义(P=0.06)。C组中有1例肝内胆管不完全充盈,D组均为造影剂不完全充盈。C组和D组均无造影信号的外溢。C组造影满意持续时间(82±8)s,和A组、B组的造影满意持续时间之间差异均有统计学意义(P<0.01)。在造影剂完全充盈和造影信号外溢方面A组和D组间差异有统计学意义(P=0.03),A组和B组、C组之间差异均无统计学意义(P>0.05)。结论经胆道途径给药超声造影研究胆管灌注是可行的,造影剂浓度不宜过低,1/200稀释浓度的成像效果最佳。
Objective To investigate the feasibility of biliary duct perfusion through ultrasound bile duct approach. Methods Sixteen male Japanese rabbits were used to free the extrahepatic bile duct. The 22G catheter was inserted into the common bile duct and fixed. According to contrast agent concentration divided into 4 groups, each group 4, respectively, A group: ultrasound contrast agent for the 1/100 standard concentration; B group: ultrasound contrast agent for the 1/200 standard concentration; C group: ultrasound contrast agent for 1 / 400 standard concentration; Group D: ultrasound contrast agent for the 1/800 standard concentration. After administration, observe whether microbubble perfusion in the intrahepatic bile duct is completely filled in the contrast-enhanced ultrasound imaging mode, whether the contrast signal is spilled or not and the duration of contrast imaging is satisfactory. Results Sixteen rabbits were successfully injected with ultrasound contrast agent (5 m L). A group of intrahepatic bile ducts were fully filled, and there is a spillover of imaging signals; B group were completely filled with intrahepatic bile duct, and 1 case of contrast signal spillover occurred. The duration of satisfactory angiography in group A and group B was (340 ± 29) and (284 ± 37) s, respectively, with no significant difference (P = 0.06). One patient in group C had incomplete filling of intrahepatic bile duct, while group D was incompletely filled with contrast medium. There was no spillover of contrast signal in group C and group D. The satisfactory duration of angioplasty in group C (82 ± 8) s, and the satisfactory duration of angiography in group A and group B were all statistically significant (P <0.01). The difference between group A and group D was statistically significant (P = 0.03). There was no significant difference between group A and group B and group C (P> 0.05). Conclusion Intrahepatic bile duct infusion contrast echocardiography is feasible for bile duct perfusion. The concentration of contrast medium should not be too low, and the imaging efficiency of 1/200 dilution is the best.