急性肠系膜上动脉闭塞性肠系膜缺血动物模型MDCT征象和组织病理学的对照研究
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四川省南充市科学技术局市校合作专项(22SXZRKX0006); 重庆市中青年医学高端人才项目(YXGD202472);


Radiologic and Histopathologic correlation of acute mesenteric ischemia caused by superior mesenteric artery occlusion:an animal study
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    目的:旨在观察急性肠系膜上动脉闭塞性肠系膜缺血动物模型的肠缺血损伤的MDCT影像征象及其与肠缺血损伤的组织病理学评分的相关性。方法:选取18只新西兰大白兔作为研究对象,随机分为1个对照组和5个肠缺血损伤组,通过结扎兔肠系膜上动脉建立急性肠缺血损伤模型。在结扎肠系膜上动脉后0.5、1、2、4和6 h后,5个肠缺血组分别接受腹部平扫及增强MDCT检查。在MDCT上观察随着缺血时间延长而呈现的肠缺血损伤影像征象的变化,并在MDCT上测量肠壁CT值,分析肠壁CT值与肠缺血损伤组织病理学评分(Park/Chiu评分)的相关性。结果:当缺血时间<2 h(Park/Chiu评分0~5分)时,MDCT显示肠壁强化程度减弱或消失,肠腔积液及扩张;缺血时间>4 h(Park/Chiu评分4~7分),除上述两种征象外,MDCT上显示肠壁变薄和肠壁间积气。MDCT平扫(R=-0.56,95%CI:-0.77~-0.25,P=0.001)、静脉期增强图像上(R=-0.85,95%CI:-0.93~-0.71,P<0.001)肠壁CT值,以及绝对强化值(R=-0.80,95%CI:-0.89~-0.64,P<0.001)与肠缺血损伤组织病理性评分(Park/Chiu评分)负相关。结论:随着缺血时间延长和肠缺血损伤的Park/Chiu评分升高,MDCT上显示肠缺血损伤的定性影像征象增多,缺血肠壁的CT值逐渐减小。MDCT上测量肠壁CT值和绝对强化值可以作为量化肠缺血损伤严重程度的量化指标。

    Abstract:

    Objective:To describe the multi detector computed tomography(MDCT)findings of arterial occlusion of acute mes-enteric ischemia in an animal model and its correlation with the histopathological scoring system.Methods:18 New Zealand white rab-bits were divided into one control group and five ischemic groups.An acute intestinal ischemia injury model was established by ligating the rabbits'superior mesenteric artery(SMA).After ligation of the superior mesenteric artery at 0.5,1,2,4,and 6 hours,the five ische-mic groups underwent abdominal plain scan and enhanced MDCT examination,respectively.Observed the changes in imaging features of intestinal ischemic injury with prolonged ischemia time on MDCT,measured intestinal wall CT values on MDCT,and analyzed the corre-lation between intestinal wall CT values and histopathological scores of intestinal ischemic injury tissue(Park/Chiu score).Results:At the time point of ischemia no more than 2 hours(Park/Chiu score ranged from 0 to 5),absent or reduced BW enhancement,and effu-sion and dilation of bowel lumen(BL)were found on MDCT.At the time point of ischemia more than 4 hours(Park/Chiu score ranged from 4 to 7),except for the above two signs,BW thinning and pneumatosis intestinalis(PI)were found on MDCT.The attenuation val-ues at BW on the MDCT plain images(R=-0.56,95%CI:-0.77~-0.25,P=0.001),and venous phase enhanced images(R=-0.85,95%CI:-0.93~-0.71,P<0.001),and absolute enhancement values(R=-0.80,95%CI:-0.89~-0.64,P<0.001)were negatively correlated with the pathological score of intestinal ischemic injury tissue(Park/Chiu score).Conclusion:With the ischemia time prolongs and increasing Park/Chiu score,the qualitative imaging features of intestinal ischemia injury on MDCT in-crease,and the CT value of ischemic intestinal wall gradually decreases.The measurement of intestinal wall CT values and absolute en-hancement values on MDCT can be used as quantitative indicators to quantify the severity of intestinal ischemic injury.

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唐伟;雷燕;李兴辉;杨慧敏;彭松;王毅;.急性肠系膜上动脉闭塞性肠系膜缺血动物模型MDCT征象和组织病理学的对照研究[J].川北医学院学报,2025,40(5):551-556.

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  • 在线发布日期: 2025-07-09
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