彩色多普勒血流定量技术与超声造影技术对慢性肾脏病患者肾血流灌注的对比研究  

Comparative study on renal perfusion in patients with chronic kidney disease by color Doppler flow quantification and contrast-enhanced ultrasound

作　　者：王明月[1] 勇强[1] 付静静 田菊[1] 濮恬宁 WANG Mingyue;YONG Qiang;FU Jingjing;TIAN Ju;PU Tianning(Department qf Comprehensive Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所综合超声科,100029

出　　处：《心肺血管病杂志》2021年第10期1063-1066,1083,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:以超声造影(CEUS)技术为金标准,比较彩色多普勒血流定量(CDFQ)技术与CEUS技术对慢性肾脏病(CKD)患者肾血流灌注的一致性。方法:选取2020年1月至2021年4月于我院确诊为CKD患者42例,其中13例患者行肾穿刺检查,收集患者年龄、血压、Glu、血肌酐(Scr)等生化指标及病理结果,计算估算的肾小球滤过率(eGFR),行CDFQ和CEUS技术检查,根据eGFR水平,将患者分为组1:eGFR≥60 mL·min^(-1)·1.73 m^(-2)(n=15),组2:eGFR<60 mL·min^(-1)·1.73 m^(-2)(n=27),分别对两组患者的CDFQ和CEUS技术检查结果进行一致性分析,探讨CDFQ技术对不同严重程度的CKD患者肾脏血流灌注的应用价值。结果:与CEUS技术相比,组1患者CDFQ技术检查诊断符合率为86.7%,灵敏度为73.3%,特异度为100%,误诊率0%,漏诊率26.7%,阳性预测值100%,阴性预测值78.9%,两种检测方法一致性尚可(Kappa值0.733,P<0.001)。组2患者CDFQ技术检查诊断符合率为90.7%,灵敏度为70.6%,特异度为100%,误诊率0%,漏诊率29.4%,阳性预测值100%,阴性预测值88.1%,两种检测方法一致性较好(Kappa值为0.767,P<0.001)。结论:CDFQ技术具有无创、操作简便等优点,可作为CKD患者肾内血流量分析的常规影像学检查方法,且更适用于eGFR<60 mL·min^(-1)·1.73 m^(-2)的CKD患者。Objective:With contrast-enhanced ultrasound(CEUS)technology as the gold standard,compared the consistency of color Doppler flow quantification(CDFQ)and CEUS in renal perfusion in patients with chronic kidney disease(CKD).Methods:A selection of 42 patients with CKD diagnosed in our hospital from January 2020 to April 2021,of which 13 patients underwent renal biopsy,and the patient’s age,blood pressure,blood glucose(Glu),serum creatinine(Scr),glomerular filtration rate(eGFR)and pathological result were collected.According to the level of EGFR,the patients were divided into group 1:eGFR≥60 mL·min^(-1)·1.73 m^(-2)(n=15)and group 2:eGFR<60 mL·min^(-1)·1.73 m^(-2)(n=27).The consistency of CDFQ and CEUS examination result of the two groups was analyzed to explore the application value of CDFQ technique in renal blood perfusion of CKD patients with different severity.Results:Compared with CEUS technology,the diagnostic coincidence rate of CDFQ technology in group 1 patients was 86.7%,the sensitivity was 73.3%,the specificity was 100%,the misdiagnosis rate was 0%,the missed diagnosis rate was 26.7%,the positive predictive value was 100%,and the negative predictive value was 78.9.%,the consistency of the two detection method is acceptable(Kappa value 0.733,P<0.001).In group 2 patients,the diagnostic coincidence rate of CDFQ technical examination is 90.7%,the sensitivity is 70.6%,the specificity is 100%,the misdiagnosis rate is 0%,the missed diagnosis rate is 29.4%,the positive predictive value is 100%,and the negative predictive value is 88.1%.Two detection method The consistency is good(Kappa value is 0.767,P<0.001).Conclusions:CDFQ technology has the advantages of non-invasiveness and easy operation.It can be used as a routine imaging examination method for renal blood flow analysis in CKD patients,and it is more suitable for CKD patients with eGFR<60 mL·min^(-1)·1.73 m^(-2).

关 键 词：彩色多普勒血流定量 超声造影 肾血流灌注 慢性肾脏病 

分 类 号：R54[医药卫生—心血管疾病]