The Valueof Acoustic Radiation Force Impulse Imagingin Quantitative Evaluationof Hepatic Ischemia Reperfusion Injuryin Cirrhotic Rabbits

Objective : Hepatic ischemia reperfusion injury(IRI)is one of the main reasons that cause liver failure in patients with cirrhosis related liver disease underwent partial hepatectomy or liver transplantation,noninvasive monitor and prevent hepatic IRI is conducive to improve the operation safety coefficient.This paper aims to evaluate the feasibility and application value of Acoustic Radiation Force Impulse(ARFI)technique in noninvasive monitoring rabits with chronic liver fibrosis IRI.Materials and methods: Rabbit modle of liver cirrhosis was made by subcutaneous injection of 50% CCL4-olive oil solution.Forty-five Successful establishment liver cirrhosis rabbits were randomly divided into Sham operation group(group A),hepatic IRI group(group B),hepatic IRI + Left liver resection group(group C),with 15 animals/group,group A underwent laparotomy 30 min,group B was produced by occlusion of hepatic pedicle for 30 min and then reperfusion for 0h,1h,6h and 24 h respectively,group C simultaneous resection of left liver on the basis of group B.Using ARFI technique measured thestiffness of rabbit right liver parenchyma at pre-ischemia and each time point of reperfusion at the same position.The transferase in serum aspartate amino(AST),alanine aminotransferase(ALT)levels was detected to evaluate liver function in the corresponding time.The liver sample of each group was performed by HE staining and then observed the pathological changes and calculate the total score of histological analysis.Statistical analysis was performed using ANOVA,the correlation between value of SWV by ARFI and ALT,AST and histological integration using Pearson correlation analysis.Results: Compared with the sham operation group,the value of SWV,serum AST,ALT levels in group B and C in the early stages of reperfusion 0h and 1h was statistically significant(P<0.05),and the pathological stage of liver cells in group B and C showed liver cell edema,liver plate narrowing,erythrocyte aggregation in hepatic sinusoids,central vein,portal vein lumen obstruction caused by microcirculation,manipulus neutrophil infiltration,suggesting that at early reperfusion,hepatic blood flow recovery after ischemia causing liver microcirculation function confusion,at reperfusion 6h,value of SWV,serum AST and ALT levels in group B and C were further increased compare with reperfusion 0h and 1h(P<0.05,this moment hepatocyte edema aggravated with balloon degeneration,when coming reperfusion 24 h,the value of SWV SWV,serum AST and ALT levels continued to rise up to peak,sustained ischemic injury leads to liver cell degeneration and necrosis.cell shrinkage,liver sinus collapse.Value of SWV in group B and C was consistent with pathological changes.Pearson correlation analysis showed that value of SWV with serum ALT,AST levels and pathological tissue morphology was significantly positive correlation(P<0.05).Conclusion: ARFI can dynamically monitor the microcirculationdisturbance and the degree of ischemia reperfusion injury of liver IRI in cirrhotic rabbits,and provide theoretical basis for clinical evaluation of hepatic IRI.