| I. The study of making animal models of solid-organ injury inblunt abdominal traumaObjective: To make animal models of solid-organ injury in blunt abdominal trauma by using self-made miniature impactor.Methods: One group including 10 pigs, 10. dogs and other 10 dogs which have been heparinized allover the bodies were impacted respectively on hepatic, splenic or renal region to make animal models of solid-organ injury with active bleeding in blunt abdominal trauma .The other group, including 10 pigs, 10 dogs and other 10 dogs without heparinization, for blunt solid-organ injury with hematomas in blunt abdominal trauma by using self-made miniature impactor(the mean power were 7.01kN,the distance of impacting was from 3cm to 5cm). After experiment, the animals were killed and their livers, spleens or kidneys were taken out of the bodies for gross pathologic examination and HE staining to evaluate the organ injuries. Results: Injuries in various degrees happened in the parenchyma of livers,spleens or kidneys. The parenchyma and capsules were ruptured in different degrees. The scales of all the organ injuries were from II to IV and the scales were more serious when the distance of impacting increased. The findings under the light microscope after HE staining: the fundamental units of the livers, spleens or kidneys, such as hepatic lobules, splenic corpuscle and glomerulus were damaged. Cells degeneration and necrosis happened in focal injuried place. There are many neutrophilic granulocytes or lymph corpuscles aggregating around the damaged region. There were different scales of blood gathered under captures and blood clotting was not happened in the animal models of solid-organ injury with active bleeding.There were different sizes and shapes blood clots found in every case of the animal models of solid-organ injury with hemaomas in blunt abdominal trauma.Conclusions: The animal models of solid-organ injury in blunt abdominal trauma by using self-made miniature impactor were controllable and stable, which can serve for our next experiments. The models can be divided into heparinized group for blunt solid-organ injury with active bleeding and non-heparinized group for blunt solid-organ injury with hematomas. II. Contrast-enhanced sonography for evaluation of solid-organ injury with active bleeding in blunt abdominal traumaObjective: To evaluate Contrast-enhanced sonography in the diagnosis ofsolid-organ injury with active bleeding in blunt abdominal trauma.Methods: Self-made miniature impactor was used to make models ofsolid-organ injury with active bleeding in blunt abdominal trauma in 10 pigs, 10 dog and other 10 dogs. Conventional 2D-sonography and Contrast-enhanced sonography were used to detect local echo changes of the livers, spleens or kidneys before and instantly after impacting. After experiments the livers, spleens or kidneys were taken out for gross pathologic examination and HE staining. The findings of conventional 2D-sonography and Contrast-enhanced sonography were compared with pathologic examination results. Results: The sonographic pattern of lesions in the pigs' livers, spleens or kidneys at conventional 2D sonography was hypoechoic in various degrees or anechoic against normal parenchymawith poorly-defined margins. The ruptures of liver (spleen or kidney) capsules were observed in some cases, whereas the capsule ruptures were not showed in the other cases. The different degrees of blood accumulation were found under the captures in all cases. Contrast-enhanced ultrasonography showed the radiate enhancement of vessels was interrupted in the lesion areas in arterial phase and in portal phase in liver. The microbubbles flowed from the ruptures to the areas of blood accumulation like "Pouring Spring" or "spurting". The enhancement of lesion area was more delayed than that of healthy parenchyma. During the delayed phase the enhanced echogenicity of the normal parenchyma began to weaken, whereas the echogenicity of lesions weakened slowly. The injuried aereas were against normal parenchyma with clear borders due to contrast agent. Gross pathologic findings demonstrated that acute blunt hepatic,splenic or renal traumas and captures happened in all cases. In the injuried scales of parenchyma in liver (spleen or kidney)and liver(spleen) capsule, gross pathologic findings were consistent with the contrast-enhanced sonographic results (P>0.05). In the ruptures of kidney membrane, gross pathologic findings have significantdifferences with the contrast-enhanced sonographic results (P<0.05). Conclusions: Contrast-enhanced sonography can observe solid-organ injury with active bleeding in blunt abdominal trauma in real time, which is valuable to further clinical treatment.III. Contrast-enhanced sonography for evaluation of solid-organ injury with hematomas in blunt abdominal trauma.Objective: To evaluate Contrast-enhanced sonography in the diagnosis of solid-organ injury with hematomas in blunt abdominal trauma. Methods: Self-made miniature impactor was used to make models of solid-organ injury with hematomas in blunt abdominal trauma in 10 pigs, 10 dog and other 10 dogs. Conventional 2D-sonography and Contrast-enhanced sonography were used to detect local echo changes of the livers, spleens or kidneys before and 2h after impacting. After experiments the livers, spleens or kidneys were taken out for pathologic examination. The findings of conventional 2D-sonography and Contrast-enhanced sonography were compared with pathologic examination results.Results: Conventional 2D sonographic findings: the injuried organic (livers, spleens or kidneys) volume was enlarged and its rough sketch/profile was irregular. The hematomas were anechoic against normal parenchyma in early and its echo increased at different intensities some time after impacting with poorly-defined margins and be scattered in damaged regions. Contrast-enhanced sonographic findings: the hematomas were not enhanced in... |
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