超声造影定量参数在诊断移植肾急慢性排斥反应的临床价值  

Quantitative Analysis of Contrast-enhanced Ultrasonography in Differentiating Acute Rejection From Chronic Rejection of Transplant Kidney

作　　者：何婉媛[1] 周盛[1] 杨萍[1] 季正标[1] 王文平[1] 

机构地区：[1]复旦大学附属中山医院超声科复旦大学超声医学与工程研究所,上海市器官移植重点实验室,上海市200032

出　　处：《中国超声医学杂志》2017年第3期249-252,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市科委医学引导类项目(No.15411964900)

摘　　要：目的探讨超声造影(CEUS)定量参数在鉴别诊断移植肾急、慢性排斥反应的价值。方法移植肾患者81例,其中正常组33例,急性排斥组(AR)33例,慢性排斥组(CR)15例。超声造影结合时间-强度曲线定量分析移植肾叶间动脉、皮质和髓质的上升时间(RT)、达峰时间(TTP)、平均通过时间(mTT),采用组内相关系数(ICC)评价各造影定量参数的稳定性。结果观察者内超声造影参数RT和TTP的稳定性较好(ICC>0.75)慢性排斥组髓质的RT、TTP较急排和正常组明显延长(P<0.05)。结论超声造影定量参数可客观地反映移植肾不同状态的血流灌注,有助于鉴别诊断移植肾急、慢性排异。Objective To explore the value of quantitative analysis parameters of contrast-enhanced ultrasonography （CEUS） in differentiating acute rejection（AR） from chronic rejection （CR） of transplant kidney. Methods Total of 81 kidney recipients were examined with CEUS. The biopsy results proved 33 cases with AR; 15 cases with CR, and 33 normal patient. CEUS combined with time-intensity curve （TIC） was performed on the cortex, pyramid and in- terlobar artery to quantitative analysis rise time （RT）, time to peak （TTP）, mean transit time （mTT）. The stability of every TIC parameters was evaluated by intraclass correlation coefficient. Results Compared to the other two groups, the RT and TTP of the pyramid were significantly longer in CR group. Conclusions Quantitative analysis of CEUS can objectively react different states of the microcirculation perfusion in transplant kidney, which is helpful to the differential diagnosis AR and CR.

关 键 词：肾移植 移植物排斥 超声造影 时间-强度曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]