超声造影定量评估特发性腹膜后纤维化病情活动性  

Quantitative Evaluation of Activity of Ldiopathic Retroperitoneal Fibrosis By Contrast-enhanced Ultrasound

作　　者：赵晓宁 邵敬 王萤萤 成珍珍 刘勇 Zhao Xiaoning;Shao Jing;Wang Yingying;Cheng Zhenzhen;Liu Yong(Department of Ultrasound,Beijing-Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院超声科(北京大学第九临床医学院),北京市100038

出　　处：《中国超声医学杂志》2021年第1期54-58,共5页Chinese Journal of Ultrasound in Medicine

基　　金：首都临床诊疗技术研究及示范应用(No.Z191100006619051);北京市科委首都临床特色应用研究(No.Z171100001017043);北京市卫生与健康科技成果和适宜技术推广项目(No.2018-TG-28);首都医科大学附属北京世纪坛“无栓、无血、无痛医院”临床专项课题(No.2015-SW07);中国国家铁路集团有限公司科技研究开发计划项目(No.J2019Z604)。

摘　　要：目的探讨超声造影(CEUS)定量评估特发性腹膜后纤维化(IRF)病情活动的可行性。方法选取于我院明确诊断为IRF患者16例,回顾分析共21次完整的影像学资料。以18F-FDG PET/CT最大标准摄取值(SUVmax)≥2.76为截断值,将受检者分为活动组和非活动组。同期行常规超声、超声造影并抽血检测红细胞沉降率(ESR)及C反应蛋白(CRP)。对常规超声及超声造影结果进行分析,并评价超声指标与18F-FDG PET/CT SUVmax及ESR、CRP结果的相关性。结果活动组13例、非活动组8例。活动组11/13(84.6%)表现为弥漫性增强或线样增强;非活动组7/8(87.5%)表现为散点状增强或无增强,管壁CEUS增强特点构成比两组差异有统计学意义(χ2=11.373,P=0.009)。两组患者病变区最大厚度、ΔI值的差异均有统计学意义(P<0.05)。ΔI与SUVmax呈中度正相关,r值为0.569(P<0.01),病变厚度与SUVmax呈轻度正相关,r值为0.434(P<0.05),ΔI与ESR及CRP之间无相关性(P>0.05),SUVmax与CRP、ESR之间无相关性(P>0.05)。结论腹主动脉周围病变区CEUS增强程度与IRF活动性相关,对临床评估及随访病情有指导意义。Objective To explore the feasibility of quantitative evaluation of disease activity of idiopathic retroperitoneal fibrosis(IRF) by contrast-enhanced ultrasound(CEUS). Methods 16 IRF patients were enrolled. A total of 21 complete imaging data were retrospectively analyzed. With 18F-FDG PET/CT maximum standard uptake value(SUVmax)≥2.76 as cutoff value, subjects were divided into active group and non-active group. At the same time, conventional ultrasound, contrast-enhanced ultrasound and blood sampling were performed to detect the erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP). The results of conventional ultrasound and contrast-enhanced ultrasound were analyzed, and evaluate the correlation between ultrasound parameters and 18F-FDG PET/CTSUVmax, ESR and CRP results. Results There were 13 cases in active group and 8 cases in non-active group. In the active group, 11/13(84.6%) showed diffuse enhancement or linear enhancement, while in the inactive group, 7/8(87.5%) showed scattered enhancement or no enhancement. The difference of CEUS enhancement characteristics between the two groups was statistically significant(χ2=11.373,P=0.009). The difference in the maximum thickness and ΔI value of lesion area between the two groups was statistically significant(P<0.05). ΔI is moderately positively correlated with SUVmax, r value is 0.569(P<0.05), lesion thickness is slightly positively correlated with SUVmax, r value is 0.434(P<0.05), ΔI is not correlated with ESR and CRP(P>0.05), SUVmax is not correlated with CRP and ESR(P>0.05). Conclusions The degree of CEUS enhancement in the lesion area around the abdominal aorta is correlated with IRF activity, which is of guiding significance for clinical evaluation and follow-up.

关 键 词：超声造影 特发性 腹膜后纤维化 活动性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R572.2[医药卫生—诊断学]