超声造影评价体外冲击波碎石后靶区与非靶区肾皮质血流灌注

Evaluation of renal cortex hemoperfusion in target and non-target area after extracorporeal shock wave ltothotripsy by contrast-enhanced ultrasound

目的通过超声造影结合时间-强度曲线(TIC)分析体外冲击波碎石(ESWL)后靶区与非靶区肾皮质血管灌注的变化情况,探讨超声造影对ESWL致肾损伤的评估价值。方法 32例肾结石患者行ESWL,于ESWL后即时行超声造影检查。运用ACQ软件定量测量碎石靶区与非靶区肾皮质血流灌注参数值,比较两组造影剂到达时间(AT)、达峰时间(TTP)、达峰强度(PI)及曲线斜率(β)变化情况。结果靶区的β、PI值均小于非靶区,且二者间比较差异有统计学意义(P<0.05);靶区与非靶区的AT、TTP值比较,差异无统计学意义(P>0.05)。结论超声造影结合TIC能有效地观察肾血流灌注特征,反映肾的微小损伤。因此,可考虑将其作为一种监测ESWL致肾损伤的新手段。

Objective To analyze the changes of renal cortex hemoperfusion in target and non - target area after extraeorporeal shock wave ltothotripsy （ESWL） by contrast- entranced ultrasound （CEUS）combined with time- intensity curve （TIC） , and to explore the value of CEUS in evaluating renal injury caused by ESWL. Methods Thirty - two patients with renal calculi were treated by ESWL, then examined by CEUS. The renal cortex blood perfusion in target and non - target area was quantitatively measured by ACQ software, and the contrast agent arrival time （AT）, time to peak （TYP）, peak intensity （PI） and velocity parameters （13） in two groups were analyzed. Results The 13 and PI in target areas were lower than those in non - target areas, there was significant difference between two groups （ P 〈 0.05 ）. While there was no significant difference of AT value and TTP value between two groups （ P 〉 0.05 ）. Conclusion CEUS combined with TIC can quantitatively evaluate the changes of renal cortex hemoperfusion after ESWL, which reflect the minor renal damage. It can be a new method in observing and evaluating the renal damage caused by ESWL.