Miller Douglas L, Lu Xiaofang, Fabiilli Mario, Dou Chunyan
Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan USA.
J Ultrasound Med. 2016 Feb;35(2):373-80. doi: 10.7863/ultra.15.05015. Epub 2016 Jan 13.
Glomerular capillary hemorrhage can be induced by ultrasonic cavitation during contrast-enhanced diagnostic ultrasound (US) exposure, an important nonthermal US bioeffect. Recent studies of pulmonary US exposure have shown that thresholds for another nonthermal bioeffect of US, pulmonary capillary hemorrhage, is strongly influenced by whether xylazine is included in the specific anesthetic technique. The objective of this study was to determine the influence of xylazine on contrast-enhanced diagnostic US-induced glomerular capillary hemorrhage.
In this study, anesthesia with ketamine only was compared to ketamine plus xylazine for induction of glomerular capillary hemorrhage in rats by 1.6-MHz intermittent diagnostic US with a microsphere contrast agent (similar to Definity; Lantheus Medical Imaging, Inc, North Billerica, MA). Glomerular capillary hemorrhage was measured as a percentage of glomeruli with hemorrhage found in histologic sections for groups of rats scanned at different peak rarefactional pressure amplitudes.
There was a significant difference between the magnitude of the glomerular capillary hemorrhage between the anesthetics at 2.3 MPa, with 45.6% hemorrhage for ketamine only, increasing to 63.2% hemorrhage for ketamine plus xylazine (P < .001). However, the thresholds for the two anesthetic methods were virtually identical at 1.0 MPa, based on linear regression of the exposure response data.
Thresholds for contrast-enhanced diagnostic US-induced injury of the microvasculature appear to be minimally affected by anesthetic methods.
在超声造影诊断超声(US)暴露期间,超声空化可引发肾小球毛细血管出血,这是一种重要的非热超声生物效应。近期关于肺部超声暴露的研究表明,超声的另一种非热生物效应——肺毛细血管出血的阈值,受到特定麻醉技术中是否包含赛拉嗪的强烈影响。本研究的目的是确定赛拉嗪对超声造影诊断超声诱导的肾小球毛细血管出血的影响。
在本研究中,将仅使用氯胺酮麻醉与氯胺酮加赛拉嗪麻醉进行比较,通过使用微球造影剂(类似于Definity;Lantheus Medical Imaging公司,马萨诸塞州北比勒里卡)的1.6兆赫兹间歇性诊断超声,诱导大鼠发生肾小球毛细血管出血。对于在不同峰值稀疏压力振幅下扫描的大鼠组,通过组织学切片中发现有出血的肾小球百分比来测量肾小球毛细血管出血情况。
在2.3兆帕时,两种麻醉剂导致的肾小球毛细血管出血程度存在显著差异,仅使用氯胺酮时出血率为45.6%,氯胺酮加赛拉嗪时出血率增至63.2%(P <.001)。然而,根据暴露反应数据的线性回归,两种麻醉方法在1.0兆帕时的阈值几乎相同。
超声造影诊断超声诱导的微血管损伤阈值似乎受麻醉方法的影响极小。