超声造影时间-强度曲线对急性肾损伤的诊断价值  

The Diagnostic Value of Time-intensity Curve of Contrast Enhanced Ultrasonography in Acute Kidney Injury

作　　者：乔实[1] 贾化平[1] 梁会泽[1] 李华[1] 刘庆玉 

机构地区：[1]解放军第306医院超声医学科,北京市100101

出　　处：《中国超声医学杂志》2017年第9期833-836,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨急性肾损伤早期肾实质血流灌注的变化规律。方法将40只雄性新西兰大白兔随机分为5组,每组8只,经耳缘静脉注射顺铂建立急性肾损伤模型,于造模后6、12、24、36h及48h进行双肾超声造影检查及测血SCr,分析不同时间点造影动态图像,获取TIC曲线及相关参数。以SCr较基础值升高1.5倍或以上为AKI诊断标准,使用SPSS 22.0及Medcalc对数据进行分析,以P<0.05为差异具有统计学意义。取兔双肾做常规石蜡切片,HE染色光镜下观察。结果 T24、T36组及T48组实验兔均发生了AKI。与建模前相比,建模后T12、T24、T36组及T48组皮质RT,T24、T36组及T48组皮质PI、T_(1/2)、mTT及TTP,T36组及T48组皮质AUC及WIS均发生了显著改变(P<0.05),髓质各造影参数均未发生显著改变。部分造影指标对AKI诊断效能较佳,灵敏度较高。结论超声造影可良好的反映AKI早期肾皮质血流灌注的改变,皮质RT可较SCr早期发现AKI,且具有较好的诊断效能。Objective To explore the transformation of blood perfusion of renal parenchyma at different early stage of AKI. Methods Divide 40 male New Zealand rabbits into 5 groups randomly and every group contains 8 rabbits. Establish the AKI models through injecting cisplatin into the ear vein. The examination point-in-time of the 5 groups was before and 6,12, 24,36,48 hours after model establishment respectively. Adopt the Q-Lab software to analyze the dynamic angiogram pictures of renal parenchyma, acquire the TIC curves and the relevant parameters. Take ＂SCr≥I. 5 times higher than basic value＂ as the diagnostic standard of AKI, use the SPSS 22.0 and Medcalc to analyze the data. P〈0. 05 for the difference was statisti- cally significant. Get the renal tissue and routinely paraffin-embedded sections, the variations of the tissue of each group were observed with HE dyeing under light microscope. Results The groups of T24, T26 and T48 all got AKI. In comparison with pre-modeling, the cortical RT of T12,T24,T36 and T48, the cortical PI, T1/2 ,mTT and TTP of T24,T36 and T48, the cor- tical AUC and WIS of T36 and T48 changed significantly, no significant changes occurred to the parameters of angiogram of medulla. The diagnostic efficiency of parts of the parameters was better and had a higher sensitivity. Conclusions CEUS could reflect the change of blood circulation of renal cortex at different stage of AKI, the cortical RT could diagnose the AKI earlier than SCr and had a better diagnostic efficiency.

关 键 词：急性肾损伤 兔 顺铂 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]