超声造影在移植肾急性排斥反应的初步临床研究

Contrast-enhanced sonography in the diagnois of acute rejection of transplanted kidney

目的探讨经静脉声学造影对移植肾急性排斥反应的诊断价值。方法对18例肾移植患者进行移植肾超声造影,测量并计算峰值密度(PI)、曲线下面积(AUC)等参数,按病理和临床诊断结果将其分为正常、轻度急性排斥反应和中重度急性排斥反应3组进行对比研究。结果PI值比较,正常组(9例)与轻度急性排斥反应组(4例)之间无显著差异,正常组与中重度急性排斥反应组(5例)之间有显著差异;而AUC值,轻度和中重度急性排斥反应组与正常组之间均有显著差异。将轻度急性排斥反应组和中重度急性排斥反应组合为一组与正常组比较,则PI无显著差异,而AUC仍有显著差异。结论移植肾超声造影的血流灌注参数AUC与肾血流量密切相关,是较客观、准确的观测指标,为临床诊断移植肾急性排斥反应提供了新的方法。

Objective To investigate the value of contrast- enhanced sonography in the diagnosis of acute rejection of transplanted kidney. Methods Eighteen patients with transplanted kidneys were divided into three groups： normal group, mild- rejection group and moderate to severe - rejection group according to the parameters such as PI, AUC which were gathered and calculated after contrast- enhanced sonography. Results Nine patients were in normal group, 4 in mild- rejection group and 5 in moderate to severe - rejection group, respectively. PI had no significant difference between normal and mild- rejection group, while significant difference between normal and moderate to severe- rejection group. Meanwhile, differences of AUC value among the three groups were significant. The PI value had no significant difference between normal group and rejection group, while AUC value had significant difference. Conclusion AUC derived from contrast - enhanced sonography has close correlation with renal blood flow. As a objective and accurate index, it could provide a new method for clinical diagnosis of acute rejection in transplanted kidney.