影像学技术在急性肾损伤诊断中的研究进展

Advances in imaging for the diagnosis of acute kidney injury

急性肾损伤(AKI)是危重患者的常见并发症。肾脏影像学检查可以为AKI的诊断和治疗效果提供有价值的信息。常规超声是目前临床首选和应用最广泛的影像学技术,可对肾脏的大小和回声进行评估;超声造影能灵敏地评估肾脏微循环,有望成为评估AKI早期肾脏血流灌注的可靠方法。计算机断层扫描(CT)能清晰地显示梗阻位置和狭窄程度,增强CT和CT灌注成像可以评估肾小球滤过率(GFR)和血流灌注情况。功能磁共振成像(fMRI)评价AKI功能方面的应用越来越多,不同的fMRI方法可以反映AKI不同的病理生理学变化。核医学检查可评估肾脏的血流灌注情况,通过计算GFR和有效肾血浆流量能有效评估肾功能。本文将对超声、CT、fMRI及核医学成像在AKI中的应用及新进展进行综述。

Acute kidney injury(AKI)is a common complication in critically ill patients.Renal imaging can provide valuable information on the diagnosis and therapeutic effects of AKI.Different imaging techniques allow evaluation of kidney structure,morphology,perfusion and function.Conventional ultrasound is the preferred and most widely used imaging technology at present,which can evaluate the size and echo of kidney;Contrast-enhanced ultrasound can sensitively evaluate renal microcirculation and is expected to be a reliable method to evaluate renal perfusion in the early stage of AKI.Computed tomography(CT)scan can clearly show the degree and location of obstruction;enhanced CT and CT perfusion imaging can evaluate glomerular filtration rate(GFR)and blood perfusion.Functional magnetic resonance imaging(fMRI)is increasingly used to evaluate the function of AKI.Different fMRI methods can reflect the different pathophysiological changes of AKI.Nuclear medicine examination can evaluate the blood perfusion of the kidney.Renal function can be effectively evaluated by calculating GFR and effective renal plasma flow.In this review,we will summarize the application and advances of ultrasound,CT,fMRI and nuclear medicine imaging in AKI.