超声造影评价移植肾皮质不同部位的微循环灌注  

Evaluation of microcirculation perfusion on different regions of transplantation kidney cortex with CEUS

作　　者：高峰[1] 邢晋放[1] 杜联芳[1] 李凡[1] 张会萍[1] 白敏[1] 马静[1] 张佳杰[1] 

机构地区：[1]上海交通大学附属第一人民医院超声医学科,上海200080

出　　处：《中国医学影像技术》2014年第9期1403-1406,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金青年基金项目(81201100;81201097);上海市卫生局科研课题基金(2008189);上海市自然基金面上项目(12ZR1424800)

摘　　要：目的探讨CEUS评价移植肾皮质不同部位的微循环灌注特点。方法根据血清肌酐(SCr)值将40例移植肾患者分为SCr正常组和SCr异常组。经肘静脉团注SonoVue行移植肾灌注CEUS,采集动态图像。选择移植肾同一切面包膜下肾皮质(外层皮质,ROI1)、弓形动脉上方肾皮质(近髓皮质,ROI2),获得相应时间-强度曲线及定量参数,包括到达时间(AT)、上升时间(RT)、达峰时间(TTP)、绝对达峰时间(ATTP)、平均渡越时间(MTT)。比较两组患者移植肾皮质不同ROI指标间差异。结果正常移植肾的CEUS灌注期表现为近髓皮质首先开始显影,外层皮质随后显影;消退期表现为外层皮质首先开始消退,近髓皮质消退晚于外层皮质出现消退。除AT外,SCr异常组移植肾外层皮质的灌注指标较SCr正常组延迟(P<0.05)。SCr正常组与SCr异常组移植肾近髓皮质的灌注指标间差异无统计学意义。结论移植肾外层皮质较近髓皮质能够更敏感地反映微循环灌注的改变。选择移植肾外层皮质作为ROI对于早期评价移植肾微循环改变具有重要意义。Objective To compare mierocirculation flow perfusion of renal allograft cortex of different regions with CEUS. Methods Forty patients underwent kidney transplantation were divided into normal group （SCr≤130 μmol/L） and abnormal group （SCr〉130 μmol/L）. The dynamic images of CEUS were analyzed off-line with the quantitative software. Two circular ROIs were drawn in outer renal cortex （ROI） and juxtamedullary cortex （ROI2）. The time-intensity curve （TIC） and quantitative parameters, which included arrival time （AT）, rise time （RT）, time-to-peak （TTP）, absolute time-to-peak （ATTP） and mean transit time （MTT）, were obtained. Quantitative analysis was performed in the different renal allograft cortical microcirculatory perfusion between two ROIs. Results ＂Wash in phase＂ of normal renal allograft.. The microbubbles first reached into the juxtamedullary cortex, then reached into the outer cortex. ＂Wash out phase＂ of normal renal allograft： The outer cortex was firstly wash out, and the ）uxtamedullary cortex washed out later than outer cortex. CEUS parameters of outer cortex in abnormal group were higher than those of normal group except for AT. There was no significante difference of above indexes on juxtamedullary cortex between both groups. Conclusion The outer renal cortex can reflecte the changes of microeireulation flow perfusion more sensitively rather than the juxtamedullary cortex, which is important for early evaluation of renal allograft microeirculation choosing the outer cortex of the transplantation renal as ROI.

关 键 词：肾移植 超声检查 肾皮质 造影剂 

分 类 号：R617[医药卫生—外科学]