超声造影观察兔急性肾衰竭前后肾皮、髓质血流灌注变化

Contrast-enhanced ultrasound in assessing renal cortical and medullary perfusion in acute renal failure in rabbits

目的探讨超声造影（CEUS）在检测兔急性肾衰竭前后肾皮、髓质血流灌注变化中的应用。方法于家兔后腿肌注50％甘油（12～15ml／kg），建立急性。肾衰竭动物模型，分别于造模前、造模后1天行肾脏灰阶CEUS检查，并对造影的时间-强度曲线（TIC）进行分析，参数包括造影剂到达皮、髓质的时间（AT）、达峰时间（TTP）、峰值强度变化（A）、曲线下面积（Auc）及曲线上升支斜率（p）。结果造模前肾皮质A[（17．36±13．73）dB]和p[（5．38±2．08）dB／s]值均明显高于造模后A[（6．59±4．25）dB]和B[（1．58±1．41）dB／s]值（P〈0．05）。造模前肾皮质TTP[（2．46±1．76）s]和AUC[（329．31±171．70）dBs]值均明显低于造模后TTP[（5．93±4．80）s]和AUC[（722．28±354．14）dBs]值（P〈0．05）。肾皮质AT，肾髓质AT、A、TTP、AUC及8，血肌酐、尿素氮在兔肾衰竭前、后差异均无统计学意义。结论CEUS与血肌酐、尿素氮相比可更早地反映急性肾衰竭后肾皮质血流灌注的改变。

Objective To assess the application of contrast-enhanced ultrasound （CEUS） in evaluation of the renal cortical and medullary perfusion changes before and after acute renal failure （ARF） in rabbits. Methods Rabbit ARF models were established with intramuscular 50% glycerin （12-15 ml/kg） injection into rabbits＇ thighs. One day before and after ARF models establishment, CEUS was performed on each rabbit. The renal perfusion time-intensity curve （TIC） was ana- lyzed, including parameters like AT （arrival time）, TTP （time to peak intensity）, A （amplitude of peak intensity）, AUC （area under the curve）, 13 （slope rate of TIC） of renal cortex and medulla. Results The value of A and β before model establishment was （17.36±13.73） dB and （5.38±2.08） dB/s, respectively, both was significantly higher than those after glycerin injeetion （E6.59±4. 251 dB and [1. 58±1. 41] dB/s, respectively） （P〈0. 05）. The value of TTP and AUC before model establishment was （2.46 ± 1.76） s and （329.31 ± 171.70） dBs, both was significantly lower than those after injection （[-5.93±-4.80] s and [722.28±354. 14] dBs, respectively） （P〈0.05）. No significant difference was found in AT of renal cortex and AT, A, TTP, AUC, β of renal medulla, nor in SCr or BUN. Conclusion CEUS can display the changes of perfusion image of the renal cortex of the ARF earlier than SCr and BUN.