肾动脉栓塞的超声造影分析

Diagnosis of renal artery embolism with contrast-enhanced ultrasound

目的探讨肾动脉栓塞的超声造影表现及其诊断价值。方法回顾性分析10例肾动脉栓塞患者的临床和超声造影资料。超声测量肾大小，观察肾内回声以及动静脉血流信号分布情况；随后进行超声造影检查，观察造影剂在肾内的灌注过程和回声强度变化，出现肾内造影剂异常充填缺损区确诊为肾动脉栓塞。结果7例为急性肾动脉栓塞，其中2例超声造影表现为广泛肾实质无强化，余5例表现为肾一极或多处楔形无强化区；3例为局灶性陈旧性肾梗塞，超声造影表现为肾包膜下的小片无强化区。结论超声造影对肾动脉栓塞具有较高的诊断价值，可作为首选的影像学诊断方法。

Objective To evaluate contrast-enhanced ultrasound（CEUS） appearances of renal artery embolism and its clinical value. Methods Ten patients with renal artery embolism were involved. The renal size was measured, and the renal echogenicity and distribution of renal arterial and venous blood signals were observed by routine ultrasound. Then CEUS were taken, the perfusion pattern and changes of echogenicity were monitored. Results Seven patients with acute renal artery embolism were correctly indicated by CEUS,among which 2 indicated extensive non-enhancing regions in the whole renal,and 5 displayed wedge un-enhanced in one or more poles. The CEUS findings of the three patients with obsolete infarction were fragmentized non-enhanced regions under the renal envelope. Conclusions CEUS is a relatively sensitive and highly specific method to diagnose renal artery embolism,and can be used as the first screening modality for this disease.