极速多普勒在肾动脉超声检查中的应用价值

Preliminary application research of Ultrafast Doppler for renal artery ultrasonography

目的分析极速多普勒（UFD）在肾动脉超声检查中的准确性、重复性，探讨应用极速多普勒检查肾动脉的可行性。方法选取临床怀疑肾动脉病变且行传统和极速多普勒肾动脉超声检查均成功者101例，并按年龄（分为≤40岁、41～60岁、≥61岁三组）、体质指数（分为正常18．5～23．9kg／m2、偏胖24．0～27．9kg／m2、肥胖≥28．0kg／m2三组）及有无肾动脉狭窄（分为无明显狭窄和狭窄〉60％两组）进行分组，对每位受检分别采用极速多普勒和传统多普勒进行肾动脉超声检查，获取多普勒参数：肾动脉主干的收缩期峰值流速（PSV）、阻力指数（RI）、肾段间动脉加速时间（T）、每种方法所耗时间（AT），检验两种方法的一致性，比较所耗时间，研究极速多普勒的应用可行性。结果①极速多普勒组内及组间重复性好，组内相关系数（ICC）值均〉0．6；②极速多普勒检查肾动脉成功例数较传统多普勒高，但差异无统计学意义（P〉O．05）；③所有受试者及不同分组两种方法所测参数显著相关（P〈0．05）；④极速多普勒耗时短（P〈0．05）；⑤不同年龄段及肾动脉有无狭窄耗时比较差异均无统计学意义（P〉0．05），随体质指数增加，耗时增加（P〈0．05）。结论极速多普勒超声检查肾动脉成功率高，重复性及一致性好，耗时短，操作简单方便。

Objective To analyze the accuracy, repeatability and feasibility of Ultrafast Doppler for renal artery ultrasonography. Methods One hundred and one cases were selected that were suspected to have renal artery disease and were successful of conventional and Ultrafast Doppler for renal artery ultrasonography, and 101 cases were grouped by age （440 years old, 41 -60 years old, ≥61 years old）, body mass index （BMI） （normal 18.5- 23.9 kg/m2,overweight 24.0- 27.9 kg/m2,obesity ≥28.0 kg/m2） and whether there were the presence of renal artery stenosis （no significant renal artery stenosis and renal artery stenosis ≥60%）. Each case was respectively examined by conventional and Ultrafast Doppler for renal artery ultrasonography in a random order. The consistency of Doppler parameters was tested. The duration of each Doppler study was compared and the feasibility of Ultrafast Doppler for renal artery ultrasonography was explored. The Doppler parameters included：renal artery peak systolic velocity （PSV）, resistance index （RI）, renal segmental artery acceleration time （T） and time consuming （AT）. The concordence and AT of two Doppler method were compared. Results （1） Ultrafast Doppler had good reproducibility, intraclass correlation coefficient （ICC） values were 〉 0.6. （2） For renal artery ultrasonography, the successful number of cases examined by Ultrafast Doppler were more than those examined by conventional Doppler, but the difference was not statistically significant （ P 〉0.05）. （3）The Doppler parameters from all subjects and different groups showed a strong positive correlation between the two Doppler studies （P 〈0.05）. （4）UltraFast Doppler required a shorter time than conventional Doppler （ P 〈0.05）. （5）The AT of cases with different ages and with or without renal artery stenosis showed no statistically significant （ P〉0.05）, however, their AT were increased with body mass index increasing （P〈 0.05）. Conclusions Ultrafast Doppler for renal artery ultrasonography has a high success rate, a good repeatability and consistency, and a shorter time consuming and simple operation than conventional Doppler.