Glomerular capillary hemorrhage induced in rats by diagnostic ultrasound with gas-body contrast agent produces intratubular obstruction.
Glomerular capillary hemorrhage induced in rats by diagnostic ultrasound with gas-body contrast agent produces intratubular obstruction.
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DOI：
10.1016/j.ultrasmedbio.2008.10.015
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发表时间：
2009-05
影响因子：
2.9
通讯作者：
Wiggins, Roger C.
中科院分区：
文献类型：
--
作者：
Miller, Douglas L.;Dou, Chunyan;Wiggins, Roger C.
关键词：
超声空化引起的肾小球毛细血管出血是一种独特的造影剂相关性肾单位损伤。本文用组织学方法观察了1.5MHz诊断超声造影剂对大鼠GCH的影响。以10 μl/kg/min输注去甲肾上腺素，持续5 min，开始8 min间歇性图像曝光，原位峰值稀疏压力振幅为2.3 MPa。分别于染毒后5 min、30 min、4 h、2 d、1 wk和4 wk取肾组织进行组织学检查。此外，在4 h时从肝素或氨基己酸处理组中取样。照射后5 min，61%的肾小球出现GCH，4 h后下降至36.3%（P<0.05），GCH组肾小球Bowman's间隙较无GCH组明显增大（P<0.05），与肾小管梗阻相一致。抗体染色显示在4小时样品中Bowman空间中的纤维蛋白凝固，并且这在2天样品中持续存在。在4 h样本中观察到肝素减少和氨基己酸增加GCH。2d后肾小管扩张明显，上皮细胞损伤。1周后，出现炎性细胞浸润区域。4周后，通过Masson三色染色显示间质纤维化区域。诊断超声与造影剂诱发GCH的后果包括肾小球毛细血管破裂、促凝血活性导致肾小管内阻塞以及由此导致的肾小管损伤向间质纤维化进展的可能性。
Glomerular capillary hemorrhage (GCH) induced by ultrasonic cavitation during diagnostic imaging represents a unique contrast-agent related nephron injury. Consequences of GCH during 1.5 MHz diagnostic ultrasound with contrast agent were examined by histological methods in rats. Definity was infused at 10 μl/kg/min for 5 min at the start of 8 min of intermittent image-exposure with 2.3 MPa in situ peak rarefactional pressure amplitude. Kidney samples were taken for histology at 5 min, 30 min, 4 h, 2 d, 1 wk and 4 wks post exposure. In addition, samples were taken at 4 h from groups treated with heparin or aminocaproic acid. GCH was found in 61% of glomeruli in the center of the scan plane 5 min after exposure, which declined (P<0.05) to 36.3 % after 4 hr. The width of Bowman’s space was significantly increased for glomeruli with GCH relative to glomeruli without GCH (P<0.05), consistent with tubular obstruction. Antibody staining revealed fibrin clotting in Bowman’s space in 4 hr samples and this persisted in the 2 d samples. Heparin reduced and aminocaproic acid increased the GCH seen in 4 h samples. Tubular dilatation was evident with injury to the epithelium after 2d. After 1 week, areas of inflammatory cell infiltration were present. After 4 weeks, areas of interstitial fibrosis were revealed by Masson’s trichrome stain. The consequences of GCH induced by diagnostic ultrasound with contrast agents include rupture of glomerular capillaries, procoagulant activity resulting in intra-tubular obstruction, and the potential for progression of the resulting tubular injury toward interstitial fibrosis.
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影响因子：
2.9
作者：
Li, P;Armstrong, WF;Miller, DL
通讯作者：
Miller, DL
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作者：
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作者：
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通讯作者：
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37.8
作者：
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通讯作者：
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