超声向量血流成像评估门静脉壁面剪切应力与肝脏再生的相关性：大鼠门静脉狭窄模型研究
本研究利用超声向量血流成像（V FLOW）定量测量不同程度及部位门静脉狭窄（PVS）大鼠模型的门静脉壁面剪切应力（WSS），并分析其与肝脏再生率（LRR）和PCNA表达的关系。结果显示狭窄后段WSS（WSSpost）及狭窄前后WSS比值（WSSR）与LRR和PCNA均呈显著负相关，WSSR对LRR和PCNA的诊断AUC分别达0.813和0.907。提示V FLOW所测WSS对无创评估肝脏再生具有潜在价值。
要点
- V FLOW可稳定测量门静脉狭窄前后WSS，狭窄后段WSS及WSSR与肝脏再生负相关。
- WSSR对肝脏再生率及PCNA表达的诊断AUC分别为0.813和0.907，优于单一WSSpost。
- 门静脉狭窄程度越重肝脏再生越差，术后7天和14天重度狭窄组LRR显著低于中度狭窄组和部分肝切除组。
关键影像表现/征象
- V FLOW在不同类型门静脉狭窄中均可获得稳定的WSS测量值。
- 狭窄前段WSS（WSSpre）在术后第7天显著下降，而狭窄后段WSS（WSSpost）在术后前3天升高。
- 中度狭窄组中，肝门部狭窄较非肝门部狭窄导致更低的WSSpre和更高的WSSR（p < 0.05）。
诊断标准与关键数值
- 中度门静脉狭窄的狭窄比率为56.57% ± 3.50%，重度狭窄比率为68.21% ± 1.89%。
- WSSpost与LRR的相关系数r = -0.60，与PCNA的r = -0.558（p < 0.05）；WSSR与LRR的r = -0.572，与PCNA的r = -0.534（p < 0.05）。
- WSSR对LRR诊断的AUC为0.813，对PCNA表达的AUC为0.907。
临床应用与阅片要点
- 在门静脉狭窄模型中，可关注狭窄后段WSS及狭窄前后WSS比值，二者与肝脏再生负相关，WSSR诊断效能更佳。
- 狭窄部位影响WSS参数：肝门部狭窄中度狭窄时WSSpre更低、WSSR更高，判读时需考虑狭窄位置。
- 术后早期（前3天）WSSpost升高、第7天WSSpre下降，动态监测可能有助于评估再生状态。
局限性
- 研究为大鼠动物模型，结论外推至临床人群需谨慎。
- 样本为单一种属、单一中心实验设计，未报告重复测量的一致性分析。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: This study aimed to quantitatively assess portal venous wall shear stress (WSS) using ultrasound vector flow imaging (V FLOW) in rat models with different degrees and sites of portal vein stenosis (PVS), and to investigate the relationship between V FLOW-derived WSS parameters and liver regeneration.
METHODS: Seventy-five male Sprague-Dawley rats were assigned to a partial hepatectomy (PH) group (n = 15) or to moderate and severe PVS groups (PVSM and PVSS, n = 30, respectively). PVS was induced at either the hilum or non-hilum site (n = 15, respectively). All rats underwent 70% PH, followed by stenosis induction in the PVS groups. Portal venous WSS was measured using V FLOW pre-operatively and on post-operative days 1, 2, 3, 7, and 14. In PVS rats, WSS at pre-stenotic (WSSpre) and post-stenotic segments (WSSpost) was obtained, and a WSS ratio (WSSR = WSSpost/WSSpre) was calculated. Rats were sacrificed at corresponding timepoints for liver regeneration rate (LRR) and proliferating cell nuclear antigen (PCNA) assessment. Temporal changes in WSS, LRR, and PCNA were compared, and correlations of WSS with LRR and PCNA were analyzed.
RESULTS: A total of 60 rats with moderate or severe PVS were successfully established, with PVS ratios of 56.57% ± 3.50% and 68.21% ± 1.89%, respectively. Liver regeneration decreased with increasing stenosis severity, and LRR in the PVSS group was significantly lower than those in the PVSM and PH groups on post-operative days 7 and 14 (p < 0.05). The PCNA expression in the PVSS group was significantly lower than that in the PVSM group. V FLOW yielded stable WSS measurements across PVS types. In PVS rats, WSSpre decreased significantly by day 7, while WSSpost increased during the first 3 days. In PVSM, hilum stenosis resulted in lower WSSpre and higher WSSR compared with non-hilum stenosis (p < 0.05). Both WSSpost and WSSR showed significant negative correlations with LRR (r = -0.60 and -0.572, p < 0.05) and PCNA (r = -0.558 and -0.534, p < 0.05). WSSR demonstrated the best diagnostic performance for LRR and PCNA expression, with area under the curves (AUCs) reaching 0.813 and 0.907, respectively.
CONCLUSION: Portal venous WSSpost and WSSR detected by V FLOW in PVS are negatively correlated with the LRR and PCNA, suggesting that WSS has potential value in non-invasive evaluation of liver regeneration.
引用
- Peng C, Yang F, Luo Y, et al. Correlation Between the Portal Venous Wall Shear Stress Using Ultrasound Vector Flow Imaging and Liver Regeneration in Rats With Portal Vein Stenosis. Ultrasound Med Biol. 2026. PMID: 42108135. doi:10.1016/j.ultrasmedbio.2026.04.006
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。