超声动态评估组织灌注技术评价糖尿病患者肾脏皮质血流灌注  

Evaluation on renal cortex blood flow in diabetic patients with dynamic sonographic tissue perfusion measurement

作　　者：姬冰[1] 刘明辉[1] 谢娟娟[1] 

机构地区：[1]中南大学湘雅二医院超声科,湖南长沙410011

出　　处：《中国医学影像技术》2011年第2期353-356,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨应用超声动态评估组织灌注(DTPM)技术定量评价糖尿病患者肾脏皮质血流灌注的临床价值。方法 65例糖尿病患者,根据肾小球滤过率分为4组:正常或升高组(Ⅰ组)、轻度下降组(Ⅱ组)、中度下降组(Ⅲ组)、重度下降组(Ⅳ组)。应用DTPM技术检测糖尿病各组及40名正常人(对照组)肾皮质感兴趣区(ROI)内平均灌注强度(Imix)、平均血流速度(Vmix)及组织阻力指数(TRI),同时将ROI平分为10个亚感兴趣区(sub-ROI),P010-ROI至P100-ROI,观察灌注强度频数分布曲线的偏度变化。结果①糖尿病Ⅰ组与对照组相比,Imix、Vmix值差异有统计学意义(P<0.05),TRI值差异无统计学意义(P>0.05),糖尿病Ⅱ组与对照组相比,I mix、Vmix及TRI值差异无统计学意义(P>0.05),上述两组灌注强度频数分布曲线的偏度于近似P050-ROI处达到最大;②糖尿病Ⅲ、Ⅳ组与对照组比较,I mix、Vmix及TRI值差异有统计学意义(P<0.05),尤其以糖尿病Ⅳ组明显,上述两组灌注强度频数分布曲线的偏度在P010-ROI至P100-ROI逐渐上升;③对照组灌注强度频数分布曲线的偏度在P010-ROI至P100-ROI逐渐上升;④除Ⅰ组外,其余糖尿病各组I mix、Vmix值随肾小球滤过率(GFR)降低而降低,TRI值随GFR降低而升高;对照组I mix、Vmix有随年龄增长而降低的趋势,但TRI变化不明显。结论 DTPM为无创定量糖尿病患者肾脏皮质血流灌注提供了新的参数指标。Objective To observe the clinical value of using dynamic sonographic tissue perfusion measurement（DTPM） to quantify cortex blood perfusion in diabetic patients.Methods Blood flow of renal cortex was analyzed using DTPM to obtain mean flow intensity（Imix）,mean flow velocity（Vmix） and tissue resistance index（TRI） in 40 healthy controls（control group） and 65 diabetic patients,the latter were classified into group Ⅰ—Ⅳ according to glomerular filtration rate（GFR）.The region of interest（ROI） was divided horizontally into 10 equal sub-region of interest（sub-RO,P010-ROI to P100-ROI） to compare skewness of perfusion intensity frequency distribution curve.Results ①There were significant differences between diabetic group Ⅰ and control group in Imix and Vmix（P0.05）,but TRI was not significantly different in the above two groups（P0.05）,whereas there was no statistical difference between diabetic group Ⅱand control group in Imix,Vmin and TRI（P0.05）.Skewness of perfusion intensity distributions approximatively peaked in P050-ROI of diabetic group Ⅰ and Ⅱ.②Compared to control group,Imix,Vmin and TRI were significantly different in diabetic group Ⅲ and Ⅳ（P0.05）,especially in diabetic group Ⅳ.Skewness of perfusion intensity distributions tended to rise from P010-ROI to P100-ROI in the above two groups.③Skewness of perfusion intensity distributions tended to rise from P010-ROI to P100-ROI in control group.④In addition to diabetic group Ⅰ,significant drop of Imix and Vmin were found with the reduction of GFR,but TRI showed increasing with the reduction of GFR.And with age,Imix and Vmix in control group decreased but TRI increased obviously.Conclusion DTPM can provide new parameters to quantify renal cortex blood flow non-invasively.

关 键 词：超声检查 肾皮质 血液灌注 糖尿病 

分 类 号：R445.1[医药卫生—影像医学与核医学]