超声造影定量技术评价兔急性肾功能衰竭早期灌注改变

Quantitative Evaluation of Contrast-enhanced Ultrasound in the Early Diagnosis of Acute Renal Failure of Rabbits

目的探讨超声造影定量分析技术在兔急性肾功能衰竭早期诊断中的应用价值。方法18只新西兰白兔后腿肌注50%甘油等渗盐水12ml/kg,建立急性肾小管坏死性肾功能衰竭(ARF)模型。分别在注射前与注射后6h进行超声造影检查,采用Q-LAB软件测量肾皮质的超声造影灌注参数值,包括曲线上升支斜率(A)、曲线下降支斜率(α)、曲线下面积(AUC)、曲线达峰绝对值(DPI)、达峰时间(TTP)。检测注射前和注射后6h兔血肌酐和尿素氮水平。结果注射前A和α值分别为(3.07±1.83)dB/s和(0.19±0.15)/s,明显高于注射后6h的(2.76±1.31)dB/s和(0.09±0.02)/s(P均<0.05)。注射前AUC和TTP值分别为(137.4±68.4)dBs和(6.33±3.71)s,明显低于注射后6h的(309.5±88.9)dBs和(8.61±3.97)s(P均<0.01)。注射前和注射后6h的DPI和血肌酐、尿素氮值差异无显著性(P>0.05)。结论超声造影定量分析技术能准确显示出兔ARF早期的血液动力学变化,较常规血肌酐、尿素氮检查灵敏,对ARF前期诊断具有一定的应用价值。

Objective To evaluate the early diagnostic value of contrast-enhanced ultrasound （CEUS） in acute renal failure （ARF） of rabbit. Methods The rabbit model of ARF was established by intramuscular injection of 50% glycerin （12 ml/kg） into the hind legs of 18 New Zealand rabbits. CEUS was performed for both kidneys before injection and 6 hours after the injection. The slope rate of ascending curve （ A）, the slope rate of descending curve （ α）, area under curve （AUC） , derived peak intensity （ DPI）, and time to peak （TIP） were measured in renal cortex of rabbits using Q-lab software package. Blood serum urea nitrogen （BUN） and serum creatinine （SCr） were measured. Results The values of A and α before the injection of glycerin were （3.07 ± 1.83 ） dB/s and （0. 19 ± 0. 15 ）/s, respectively, which were significantly higher than the values after injection [ （2. 76 ± 1.31 ） dB/s and （0. 09 ± O. 02）/s, respectively ] （ P 〈 0. 05 ）. The values of AUC and TIP before the injection of glycerin were （ 137.4 ±68.4） dB s and （6.33 ±3.71 ） s, which were significantly lower than the values after injection [ （309.5 ±88.9） dB s and （8.61 ±3.97） s, respectively] （P 〈 0. 01 ）. No significant change of DPI, BUN or SCr was found. Conclusions CEUS can precisely display the hemodynamic change of ARF model of rabbit in the early stage, with superior sensitivity than BUN and SCr. It may be a promising imaging method for the early diagnosis of ARF.