Paltiel Harriet J, Kalish Leslie A, Susaeta Ricardo A, Frauscher Ferdinand, O'Kane Patrick L, Freitas-Filho Luiz G
Department of Radiology, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
Radiology. 2006 Jun;239(3):718-29. doi: 10.1148/radiol.2393050210. Epub 2006 Apr 26.
To quantitatively and qualitatively assess perfusion with pulse-inversion (PI) ultrasonography (US) in rabbit model of acute testicular ischemia.
Institutional animal care committee approval was obtained. After 35 rabbits underwent unilateral spermatic cord occlusion, testicular Doppler US and contrast material-enhanced PI imaging were performed. Enhancement data yielded perfusion measurements including mean value during the first 10 seconds, mean value over entire recorded replenishment curve, and curve slope during the first 5 seconds. Calculated perfusion ratios were compared with radiolabeled microsphere-derived perfusion ratios. Two readers assessed testicular perfusion as none, possible, or definite and relative perfusion as greater to the right testis than to the left, greater to the left testis than to the right, or as equal to both testes. With kappa statistics, interobserver agreement for all imaging methods was determined. Association between qualitative perfusion categories and radiolabeled microsphere-based perfusion measurements was assessed. Quantitative and qualitative determinations of relative perfusion were compared with radiolabeled microsphere-based measurements.
Correlations between calculated and radiolabeled microsphere-based perfusion ratios were determined (r=0.49-0.64). Interobserver agreement for presence of perfusion was excellent (kappa=0.76), and that for relative perfusion assessment was good (kappa=0.55). Neither kappa value varied significantly with imaging method. The percentage of times a testis classified as having definite perfusion had greater perfusion as measured with radiolabeled microspheres than a testis classified as having no perfusion or possible perfusion was higher with PI imaging than with Doppler US (85%-98% vs 72%-89%). Identification of the testis with less perfusion was better with quantitative methods than with qualitative assessment of images by the readers (75%-79% vs 34%-60%, P<.004).
PI imaging, compared with conventional Doppler US methods, provides superior assessment of perfusion in the setting of acute testicular ischemia.
在急性睾丸缺血兔模型中，对脉冲反转（PI）超声（US）灌注进行定量和定性评估。
获得机构动物护理委员会批准。35只兔子单侧精索闭塞后，进行睾丸多普勒超声和对比剂增强PI成像。增强数据产生灌注测量值，包括前10秒的平均值、整个记录的再充盈曲线的平均值以及前5秒的曲线斜率。将计算出的灌注比值与放射性标记微球衍生的灌注比值进行比较。两名阅片者将睾丸灌注评估为无、可能或确定，将相对灌注评估为右侧睾丸大于左侧、左侧睾丸大于右侧或两侧睾丸相等。采用kappa统计分析，确定所有成像方法的观察者间一致性。评估定性灌注类别与基于放射性标记微球的灌注测量之间的关联。将相对灌注的定量和定性测定结果与基于放射性标记微球的测量结果进行比较。
确定了计算出的灌注比值与基于放射性标记微球的灌注比值之间的相关性（r = 0.49 - 0.64）。观察者间对灌注存在情况的一致性极佳（kappa = 0.76），对相对灌注评估的一致性良好（kappa = 0.55）。两种kappa值均未随成像方法而有显著变化。PI成像中，被分类为有确定灌注的睾丸，其放射性标记微球测量的灌注大于被分类为无灌注或可能灌注的睾丸的次数百分比高于多普勒超声（85% - 98%对72% - 89%）。定量方法在识别灌注较少的睾丸方面优于阅片者对图像的定性评估（75% - 79%对34% - 60%，P <.004）。
与传统多普勒超声方法相比，PI成像在急性睾丸缺血情况下对灌注的评估更优。
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