超声造影在移植肾术后的应用价值研究

Study on the value of contrast-enhanced ultrasound after renal transplantation

目的:探讨超声造影(CEUS)在移植肾术后肾功能监测及并发症诊断中的价值。方法:29例同种异体肾移植患者,术后时间6天至6年,常规超声检查后行超声造影检查,存储图像。选择移植肾中部包膜下皮质作为感兴趣区,通过时间强度曲线测定相关参数:到达时间(AT),达峰时间(TTP),分析移植肾功能正常组与异常组之间参数的差异。结果:移植肾功能正常组13例,异常组16例,移植肾功能正常组CEUS时间强度曲线参数AT、TTP较异常组短,差异有统计学意义。移植肾肾周积液10例,CEUS表现为积液区无造影剂进入。移植肾局部梗死1例,CEUS表现为移植肾上极及下极2处"无增强区"。移植肾动脉狭窄1例,CEUS表现为血管局部细窄。结论:CEUS可以作为评价移植肾功能不全的一种可行方法,CEUS对于发现移植肾局部梗死灶及范围、鉴别移植肾周围积液、判断移植肾动脉狭窄有较大意义。

Objective To evaluate the value of CEUS in renal function monitoring and complication diagnosis after renal transplantation.Methods 29 cases of renal allograft were examined by CEUS 6 days to 6 years after operation.The middle subcapsular cortex of the transplanted kidney was selected as the area of interest,and the relevant parameters were measured by time-intensity curve:time of arrival (AT),time of peak arrival (TTP),to analyze the parameter differences between the normal group and the abnormal group.Results There were 13 cases in the normal group and 16 cases in the abnormal group,and the CEUS time intensity curve parameters AT and TTP in the normal group were shorter than those in the abnormal group,the difference was statistically significant.There were 10 cases of perirenal effusion in the transplanted kidney,and CEUS showed no entry of contrast agent in the effusion area.One patient had local infarction of the transplanted kidney,and CEUS showed "no enhancement zone" at the upper pole and lower pole of the transplanted kidney.In 1 case of arterial stenosis in renal graft,CEUS presented as narrow and narrow locally,which was confirmed by X-ray.Conclusion CEUS can be used as a feasible method to evaluate renal insufficiency in transplantation.CEUS is of great significance for the discovery of local infarction foci and scope of the transplanted kidney,the identification of fluid around the transplanted kidney,and the judgment of arterial stenosis of the transplanted kidney.