超声造影技术在肾移植术后急性排斥反应中的应用进展

Application progress on contrast-enhanced ultrasound in acute rejection after kidney transplantation

急性排斥反应的早期诊断对于移植肾功能保护具有重要意义。病理穿刺活组织检查是诊断移植肾急性排斥反应的金标准,但随之可能出现的出血、感染、肾实质损伤等并发症限制了其应用。近年来,超声造影技术诊断急性排斥反应的灵敏度不断提升,其中靶向超声微泡技术更是进一步提升了超声造影技术诊断的特异度,使其替代病理穿刺活组织检查成为可能。此外,在急性排斥反应治疗领域,空化的超声微泡可以通过诱发声孔效应,促进免疫抑制药局部传递而发挥其抗排斥反应作用。本文对超声造影技术在肾移植术后急性排斥反应的诊断及治疗中的应用进行总结,为超声造影技术在肾移植中进一步应用提供参考。

Early diagnosis of acute rejection is of significance for the protection of renal allograft function.Pathological puncture biopsy is the gold standard for the diagnosis of acute rejection of renal allografts.Nevertheless,it may provoke multiple complications,such as bleeding,infection and renal parenchymal injury,which limit its widespread application.In recent years,the sensitivity of contrast-enhanced ultrasound in the diagnosis of acute rejection has been constantly improved.Ultrasound-targeted microbubble technique has further enhanced the diagnostic specificity of contrast-enhanced ultrasound,making it possible to replace pathological puncture biopsy.Besides,in the field of acute rejection treatment,microbubble ultrasonic cavitation may promote local delivery of immunosuppressants by inducing sonoporation and exhibit anti-rejection effect.In this article,the application of contrast-enhanced ultrasound in the diagnosis and treatment of acute rejection after kidney transplantation was reviewed,aiming to provide reference for widespread application of contrast-enhanced ultrasound in kidney transplantation.