Contrast-Based Real-Time Assessment of Microcirculatory Changes in a Fatty Liver After Ischemia Reperfusion Injury.
Contrast-Based Real-Time Assessment of Microcirculatory Changes in a Fatty Liver After Ischemia Reperfusion Injury.
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DOI：
10.1097/mpg.0000000000001008
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发表时间：
2016-03
影响因子：
2.9
通讯作者：
Gupta NA
中科院分区：
文献类型：
--
作者：
Kolachala VL;Jiang R;Abramowsky CR;Gupta NA
已知脂肪肝具有微循环损伤，其在缺血再灌注损伤（IRI）后恶化。这使得大多数脂肪移植物不适合移植，并且在没有对微循环进行真实的时间评估的情况下，这种选择充其量是随机的。本研究的目的是证明对比增强超声模型在定量评估脂肪肝微循环中的实用性。我们对肥胖小鼠进行IRI，并在损伤前后评估血流动力学。肝外动脉的阻力和搏动指数显著增加，门静脉流速显著降低。脂肪肝小鼠的肝内血容量、血流量、达到峰值流量的时间和灌注指数也有可量化的减少，表明脂肪肝在IRI后发生血流动力学异常，导致肝细胞损伤增加。重要的是，这些异常可以通过使用对比增强多普勒超声进行可靠的量化，这是一种具有多种临床应用的廉价技术。它可用于在器官获取之前评估脂肪肝供体移植物的质量;用于确定活体供体候选资格，用于进行IRI后恢复预后，以及用于评估治疗干预的有效性。
A fatty liver is known to have impairment of microcirculation, which is worsened after ischemia reperfusion injury (IRI). This makes most fatty grafts unsuitable for transplantation, and in the absence of real time assessment of microcirculation this selection has been at best, random. The goal of this study was to demonstrate the utility of a contrast enhanced ultrasound model in quantitative assessment of the microcirculation of a fatty liver. We subjected fatty mice to IRI and blood flow dynamics were assessed before and after the injury. There was a significant increase in the resistive and pulsatility index of the extra hepatic artery and a significant decrease in velocity of the portal vein. There was also a quantifiable decrease in the intrahepatic blood volume, blood flow, time to peak flow, and perfusion index of mice with fatty liver suggesting that a fatty liver develops hemodynamic abnormalities after IRI, leading to increased hepatocellular injury. Importantly, these abnormalities can be reliably quantified by using a contrast, enhanced Doppler ultrasound, an inexpensive technique with multiple clinical applications. It can be used to assess the quality of the fatty liver donor graft prior to organ retrieval; for determining live donor candidacy, for making post IRI recovery prognosis, and for assessing the effectiveness of therapeutic interventions.