超声造影与核素肾动态显像在评价兔肾缺血再灌注损伤中的对比研究

COMPARISON OF CONTRAST-ENHANCED ULTRASOUND AND RADIONUCLIDE RENAL DYNAMIC IMAGING ON EVALUATION OF RABBIT RENAL ISCHEMIA-REPERFUSION INJURY

目的:探讨超声造影及核素肾动态显像在评价兔肾缺血再灌注损伤中的诊断价值,并比较两种检测手段的优劣势。方法:建立肾缺血再灌注损伤模型,分别于缺血前及缺血再灌注后24h行超声造影及核素动态显像检查,并对造影的时间-强度曲线(TIC)各参数以及核素肾动态显像的肾小球滤过率(GFR)进行分析,比较其前后变化。结果:超声造影检查组缺血前TIC曲线上升支斜率(Grad)明显高于缺血再灌注24h组,开始增强时间(arrival time,AT)、灌注峰值时间(time to peak,TTP)、曲线下面积(AUC)明显低于缺血再灌注后24h。而肾皮质灌注峰值强度变化(amplitude of peak intensity,A)值在缺血前及再灌注24h后无明显改变。核素动态显像组所得GFR值在缺血再灌注后24h较缺血前明显降低。结论:核素肾动态显像可以直接反映肾功能状态,但具有放射性损伤且误差较大。超声造影诊断能对肾脏局部血流灌注进行定量分析,间接评价肾功能状态,具有安全、费用低、重复性强、无明显禁忌症和并发症等优点。

Objective：To explore the value between Contrast-enhanced Ultrasound（CEUS） and radionuclide renal dynamic imaging on evaluation of rabbit renal ischemia-reperfusion injury,and to compare the advantages and disadvantages of these two detecting methods.Methods：The models of renal IRI were established.Before and 24 hours after the establishment of models,CEUS and radionuclide renal dynamic imaging were performed on each rabbit.The parameters of renal perfusion time-intensity curve（TIC）and the glomerular filtration rate（GFR） were analyzed.Results：The value of Grad before model establishment was significantly higher than the value of 24 hours reperfusion after rabbit renal ischemia.The value of TTP,AT and AUC of renal cortical were significantly lower than that of 24 hours reperfusion after rabbit renal ischemia.No significant difference was found in A of renal cortical.The value of GFR before model establishment was significantly higher than 24 hours reperfusion after rabbit renal ischemia.Conclusion：Radionuclide renal dynamic imaging can reflect renal cell function directly,but it has radiation damage and errors.CEUS can quantitatively analyse renal blood flow perfusion and evaluate renal cell function indirectly,safe,low cost,reproducibility,with no contraindications and complications,etc.