超声造影对急性肾损伤患者肾脏血流灌注水平的评价

Clinical value on quantitative analysis of renal perfusion in acute kidney injury by contrast enhanced ultrasound

目的分析急性肾损伤(AKI)患者肾脏超声造影(CEUS)参数的变化,探讨其评价AKI患者肾脏血流灌注水平的临床应用价值。方法选择2015年12月至2017年6月解放军第306医院收治的AKI住院患者30例,设为病例组,再按照出院时疾病转归情况,分为AKI治疗好转组、治疗未好转组2个亚组;选择2017年3月至5月32名健康志愿者设为对照组。应用声诺维团注及低机械指数(MI)技术进行肾脏CEUS检查,比较分析3组间皮质与髓质的各超声造影参数。结果 3组间比较,肾皮质的PI、MTT、AUC、TP1/2、TTP,差异有统计学意义(F=69.33、20.36、69.88、25.80、3.63,P均<0.05),髓质的RT、PI、MTT、AUC、TP1/2、TTP差异亦有统计学意义(F=22.01、37.72、27.67、47.39、33.52、8.65,P均<0.01)。好转组的肾皮质和髓质PI、AUC、MTT、TP1/2值均大于未好转组(PI、AUC,P<0.01;MTT、TP1/2,P<0.05)。结论应用超声造影技术评价AKI肾脏血流灌注水平,对AKI患者肾脏功能状态判定及预后评估有临床应用价值。

Objective To quantitatively analyze the changes of renal contrast-enhanced ultrasound(CEUS)parameters in patients with acute renal injury(AKI),and to evaluate the clinical value of CEUS in evaluating the renal perfusion changes in AKI.Methods Thirty patients with AKI were enrolled as patient group from December 2015 to June 2017,and then were subdivided into two subunits according to prognosis of the disease,which were recovery group and non-recovery group.Thirty-two healthy volunteers were enrolled as control group from March to May 2017.Contrast-enhanced ultrasound examinations with low mechanical index(MI)technology and SonoVue bolus injection were performed on all patients and volunteers.The parameters of CEUS were compared and analyzed among these three groups.Results The differences of PI,MTT,AUC,TP1/2 and TTP in renal cortex were statistically significant among the 3 groups(F=69.33,20.36,69.88,25.80,3.63,all P<0.05).The differences of RT,PI,MTT,AUC,TP1/2 and TTP in medulla were also statistically significant(F=22.01,37.72,27.67,47.39,33.52,8.65,all P<0.01).The cortical and medullary PI,AUC,MTT,TP1/2 of recovery group were greater than those of non-recovery group(PI,AUC,P<0.01;MTT,TP1/2,P<0.05).Conclusion Quantitative evaluation of AKI renal perfusion by contrast-enhanced ultrasound is of clinical value in evaluating renal function and prognosis in patients with AKI.