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Correlation between microcirculation and contrast-enhanced ultrasonography after crush injury of limbs

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Abstract

Purpose

To explore the microcirculation formation mechanism of contrast-enhanced (CE) ultrasonography imaging performance in rabbits with limb muscle crush injury.

Methods

Seventy-two New Zealand white rabbits were randomly divided into two groups. A limb muscle crush injury model was created by airing a balloon cuff device with a force of 40 kpa. CE ultrasonography parameters were detected in the first group. In vivo microcirculation parameters were detected in the second group. Fine blood vessel diameter and blood flow velocity were calculated before extrusion and 0.5, 2, 6, 24 h, and 3 days after decompression.

Results

Compared with the uninjured muscle, reperfusion of the injured muscles showed early and high enhancement in CE ultrasonography images. The time-intensity curve showed a trend of rapid elevation and gradual drop. Compared with the control group, fine artery and vein diameters in the experimental group were wider and the blood flow velocity was slower, especially in the fine veins.

Conclusion

In vivo microcirculation detection can reflect changes in muscle microvascular diameter and blood flow velocity, which have a correlation with quantitative ultrasound imaging parameters.

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References

  1. Sever MS, Vanholder R, Lameire N. Management of crush-related injuries after disasters. N Engl J Med. 2006;354:1052–63.

    Article  CAS  PubMed  Google Scholar 

  2. Ersoy A, Yavuz M, Usta M, et al. Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake: survivors vs non-survivors. Clin Nephrol. 2003;59:334–40.

    Article  CAS  PubMed  Google Scholar 

  3. Mabvuure NT, Malahias M, Hindocha S, et al. Acute compartment syndrome of the limbs: current concepts and management. Open Orthop J. 2012;6:535–43.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Zimmerman JL, Shen MC. Rhabdomyolysis. Chest. 2013;144:1058–65.

    Article  CAS  PubMed  Google Scholar 

  5. Malik AA, Khan WS, Chaudhry A, et al. Acute compartment syndrome—a life and limb threatening surgical emergency. J Perioper Pract. 2009;19:137–42.

    Article  CAS  PubMed  Google Scholar 

  6. Ulmer T. The clinical diagnosis of compartment syndrome of the lower leg: are clinical findings predictive of the disorder? J Orthop Trauma. 2002;16:572–7.

    Article  PubMed  Google Scholar 

  7. Zhang L, Fang ZJ, Liu F, et al. Magnetic resonance imaging and magnetic resonance angiography in severe crush syndrome with consideration of fasciotomy or amputation: a novel diagnostic tool. Chin Med J. 2011;124:2068–70.

    PubMed  Google Scholar 

  8. Moratalla MB, Braun P, Fornas GM. Importance of MRI in the diagnosis and treatment of rhabdomyolysis. Eur J Radiol. 2008;65:311–5.

    Article  PubMed  Google Scholar 

  9. Miles K. Measurement of tissue perfusion by dynamic computed tomography. Br J Radiol. 1991;64:409–12.

    Article  CAS  PubMed  Google Scholar 

  10. Lu CH, Tsang YM, Yu CW, et al. Rhabdomyolysis: magnetic resonance imaging and computed tomography findings. J Comput Assist Tomogr. 2007;31:368–74.

    Article  PubMed  Google Scholar 

  11. Behrooz H, Saeed S, Mostafa H, et al. A systematic review of iranian experiences in seismo-nephrology. Arch Trauma Res. 2016;5:e28796.

    Google Scholar 

  12. Krix M, Krakowski RH, Amarteifio E, et al. Comparison of transient arterial occlusion and muscle exercise provocation for assessment of perfusion reserve in skeletal muscle with real-time contrast-enhanced ultrasound. Eur J Radiol. 2013;82:419–24.

    Article  Google Scholar 

  13. Lv F, Tang J, Luo Y, et al. Contrast-enhanced ultrasound assessment of muscle blood perfusion of extremities that underwent crush injury: an animal experiment. J Trauma Acute Care Surg. 2013;74:214–9.

    Article  PubMed  Google Scholar 

  14. Zhang CD, Lv FQ, Li QY, et al. Application of contrast-enhanced ultrasonography in the diagnosis of skeletal muscle crush injury in rabbits. Br J Radiol. 2014;87:20140421.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Xiu R. Microcirculation-subtle life fountain. Chin J Microcirc. 1997;1997:3.

    Google Scholar 

  16. Rosell S. Neuronal control of microvessels. Annu Rev Physiol. 1980;42:359–71.

    Article  CAS  PubMed  Google Scholar 

  17. Kurbel S, Kurbel B, Belovari T, et al. Model of interstitial pressure as a result of cyclical changes in the capillary wall fluid transport. Med Hypotheses. 2001;57:161–6.

    Article  CAS  PubMed  Google Scholar 

  18. Granger HJ, Goodman AH, Cook BH. Metabolic models of microcirculatory regulation. Fed Proc. 1975;34:2025–30.

    CAS  PubMed  Google Scholar 

  19. Clifford PS, Hellsten Y. Vasodilatory mechanisms in contracting skeletal muscle. J Appl Physiol. 2004;97:393–403.

    Article  PubMed  Google Scholar 

  20. Van Wagoner DR, Bond M. Reperfusion arrhythmias: new insights into the role of the Na(+)/Ca(2 +) exchanger. J Mol Cell Cardiol. 2002;33:2071–4.

    Article  Google Scholar 

  21. Pang CY, Forrest CR. Acute pharmacologic preconditioning as a new concept and alternative approach for prevention of skeletal muscle ischemic necrosis. Biochem Pharmacol. 1995;49:1023–34.

    Article  CAS  PubMed  Google Scholar 

  22. Morris SF, Pang CY, Lofchy NM, et al. Deferoxamine attenuates ischemia-induced reperfusion injury in the skin and muscle of myocutaneous flaps in the pig. Plast Reconstr Surg. 1993;92:120–32.

    Article  CAS  PubMed  Google Scholar 

  23. Harkin DW, Barros D’sa AA, Mccallion K, et al. Circulating neutrophil priming and systemic inflammation in limb ischemia–reperfusion injury. Int Angiol A J Int Union Angiol. 2001;20:78–89.

    CAS  Google Scholar 

  24. Yassin MM, Harkin DW, Barros D’Sa AA, et al. Lower limb ischemia–reperfusion injury triggers a systemic inflammatory response and multiple organ dysfunction. World J Surg. 2002;26:115–21.

    Article  PubMed  Google Scholar 

  25. Muhs BE, Plitas G, Delgado Y, et al. Temporal expression and activation of matrix metalloproteinases-2, -9, and membrane type 1-matrix metalloproteinase following acute hindlimb ischemia. J Surg Res. 2003;111:8–15.

    Article  CAS  PubMed  Google Scholar 

  26. Fitzal F, Delano FA, Young C, Schmidschönbein GW. Early capillary no-reflow during low-flow reperfusion after hind limb ischemia in the rat. Ann Plast Surg. 2002;49:170–80.

    Article  PubMed  Google Scholar 

  27. Barrett EJ, Rattigan S. Muscle perfusion: its measurement and role in metabolic regulation. Diabetes. 2012;61:2661–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Sahjian M, Frakes M. Crush injuries: pathophysiology and current treatment. Nurse Pract. 2007;32:13–8.

    Article  PubMed  Google Scholar 

  29. Vollmar B, Westermann S, Menger MD. Microvascular response to compartment syndrome-like external pressure elevation: an in vivo fluorescence microscopic study in the hamster striated muscle. J Trauma Acute Care Surg. 1999;46:91–6.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Ultrasound, PLA Bethune International Peace Hospital, No. 398, Zhongshanxi Road, Shijiazhuang, 050081, People’s Republic of China

    Chundong Zhang

  2. Department of Pediatrics, PLA Bethune International Peace Hospital, Shijiazhuang, People’s Republic of China

    Xin Wang

  3. Department of Ultrasound, Chinese PLA General Hospital, Beijing, People’s Republic of China

    Jie Tang

Authors
  1. Chundong Zhang
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  2. Xin Wang
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  3. Jie Tang
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Corresponding author

Correspondence to Chundong Zhang.

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All institutional and national guidelines for the care and use of laboratory animals were followed.

Conflict of interest

All authors declare no financial competing interests. All authors declare no non-financial competing interests.

Electronic supplementary material

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10396_2017_841_MOESM1_ESM.docx

Supplementary Figure 1. Examples of CE ultrasonography images and the time-intensity curve. Compared with the control group (a), intensity of the muscle injury (b) was significantly higher, and the time-intensity curve showed a speed-up-slow-down type. (DOCX 1812 kb)

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Zhang, C., Wang, X. & Tang, J. Correlation between microcirculation and contrast-enhanced ultrasonography after crush injury of limbs. J Med Ultrasonics 45, 307–313 (2018). https://doi.org/10.1007/s10396-017-0841-2

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  • DOI: https://doi.org/10.1007/s10396-017-0841-2

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