常规超声及超声造影评价不同肾功能移植肾的血流灌注

Evaluation of blood flow perfusion of different function transplanted kidney with conventional ultrasound and CEUS

目的应用常规超声和超声造影比较不同肾功能的移植肾的灌注状况。方法根据血清肌酐(SCr)值将60例移植肾患者分为SCr正常组和SCr异常组。二维超声观测移植肾结构及主肾动脉内径;彩色多普勒超声观察主肾动脉、段动脉、叶间动脉及弓形动脉的收缩期峰值流速(PSV)、舒张期末流速(EDV)及阻力指数(RI);超声造影结合时间-强度曲线定量分析段动脉、叶间动脉、皮质及锥体的到达时间(AT)、达峰时间(TTP)、绝对强度(△I)及上升斜率(Increase);分别比较采用每种检查方法所测得的两组患者指标间差异。结果二维超声和彩色多普勒超声检查(弓形动脉EDV除外)所测得的两组患者指标间差异无统计学差异;超声造影检查SCr正常移植肾的灌注指标大部分优于SCr异常的移植肾,差异有统计学意义。结论肾功能正常移植肾的超声造影定量指标明显优于肾功能异常的移植肾,超声造影能够检测出肾功能异常移植肾的微循环灌注改变。

Objective To compare blood flow perfusion conditions of renal allograft of different renal function with conventional ultrasound and contrast enhanced uhrasonography （CEUS）. Methods Sixty patients underwent kidney transplatation were divided into normal group （SCr≤110 umol/L） and abnormal group （SCr〉110 umol/L）. Renal structure and inner diameter of renal artery were messured with two-dimensional ultrasound. The hemodynamic parameters （PSV, EDV and RI） were messured with CDFI. Data of renal blood flow perfusion （AT, TTP, △I and Increase）, data of renal blood flow perfusion （AT, TTP, △I and Increase） were quantitatively analyzed with CEUS combined with time intensity curve. All the data were compared between two groups. Results There was no significantly difference of above indexes for B-mode ultrasound and CDFI between two groups, except EDV of arcuate arteries. CEUS parameters of patients with normal renal function were better than those with abnormal function. Conclusion Microcirculation perfusion changes of transplanted kidney with abnormal function could be detected with CEUS. The quantitative indexes of transplanted kidney with normal function were better than those with abnormal function.