超声及超声造影定量分析在移植肾术后肾功能延迟恢复评价中的应用  

Application of ultrasound and contrast-enhanced ultrasound quantitative analysis in the evaluation of delayed graft function recovery after kidney transplantation

作　　者：李凤[1] 张蔚蓝 黄伟俊[1] 黄婷[1] 欧英慧[1] 陈统清[2] LI Feng;ZHANG Wei-lan;HUANG Wei-jun;HUANG Ting;OU Ying-hui;CHEN Tong-qing(Ultrasonic Diagnosis Treatment Center,Foshan First People’s Hospital,Foshan 528000,Guangdong,CHINA;Department of Nephrology,Foshan First People’s Hospital,Foshan 528000,Guangdong,CHINA)

机构地区：[1]佛山市第一人民医院超声诊疗中心,广东佛山528000 [2]佛山市第一人民医院肾内科,广东佛山528000

出　　处：《海南医学》2022年第4期494-497,共4页Hainan Medical Journal

基　　金：2021年度广东省佛山市卫生健康局医学科研课题(编号:20210386)。

摘　　要：目的探讨超声及超声造影定量分析在评价移植肾功能延迟恢复(DGF)中的应用价值。方法回顾性分析2017年1月至2019年12月在佛山市第一人民医院肾内科行肾移植术的116例患者的临床资料,根据术后早期是否需要透析、血肌酐值和尿量情况分为肾功能延迟恢复组(DGF组)25例和肾功能正常恢复组(正常组)91例,两组患者均进行常规超声及超声造影检查,二维超声测量移植肾长、宽、厚,然后根据公式计算移植肾体积,彩色多普勒超声测量叶间动脉及段动脉收缩期峰值流速(PSV)、阻力指数(RI),超声造影获取肾皮质感兴趣区域血流灌注参数如显影时间(AT)、显影强度(AI)、达峰时间(TTP)、达峰强度(PI)、绝对增强强度(△I)及曲线下面积(AUC),比较两组患者以上各项参数的差异。结果DGF组患者的二维超声参数[移植肾宽(59.88±6.93)mm、厚(57.76±7.32)mm、体积(202.72±56.57)mL]明显大于正常组[移植肾宽(53.08±7.37)mm、厚(54.14±6.11)mm、体积(163.95±48.10)mL],差异均有显著统计学意义(P<0.01);DGF组患者的彩色多普勒超声参数叶间动脉和段动脉RI分别为0.75±0.18、0.75±0.16,明显高于正常组的0.58±0.07、0.61±0.08,差异均有显著统计学意义(P<0.01);DGF组患者的超声造影参数△I和AUC分别为(30.20±3.79)Db、(2261.00±385.74)dB·s,明显低于正常组的(32.24±3.92)Db、(2509.56±379.82)dB·s,差异均有统计学意义(P<0.05)。两组间的移植肾长、叶间动脉PSV、段动脉PSV、AT、AI、TTP、PI等参数比较,差异均无统计学意义(P>0.05)。结论超声及超声造影可以对移植肾微循环血流灌注进行定量、客观、准确评价,有助于临床早期诊断DGF,进一步采取积极治疗保护肾功能,提高移植肾存活率。Objective To explore the application value of ultrasound and contrast-enhanced ultrasound quantitative analysis in the evaluation of delayed graft function(DGF)recovery after kidney transplantation.Methods The clinical data of 116 patients who underwent renal transplantation in the Department of Nephrology at Foshan first People’s Hospital from January 2017 to December 2019 were analyzed retrospectively.According to the need for dialysis,serum creatinine,and urine volume in the early postoperative period,the patients were divided into 25 cases of delayed renal function recovery group(DGF group)and 91 cases of normal renal function recovery group(normal group).Both groups underwent conventional ultrasound and contrast-enhanced ultrasound examinations.The length,width and thickness of transplanted kidney were measured by two-dimensional ultrasound,and then the volume of transplanted kidney was calculated according to the formula.The peak systolic flow velocity(PSV)and resistance index(RI)of the interlobar artery and segmental artery were measured by color Doppler ultrasound.The blood perfusion parameters of the renal cortex of interest were obtained by contrast-enhanced ultrasound,such as arrive time(AT),arrive intensity(AI),time to peak(TTP),peak intensity(PI),absolute enhancement intensity(△I),and area under the curve(AUC).The differences of the above parameters between the two groups were compared.Results The two-dimensional ultrasound parameters of the transplanted kidney in the DGF group were(59.88±6.93)mm in width,(57.76±7.32)mm in thickness,and(202.72±56.57)mL in volume,which were significantly higher than(53.08±7.37)mm in width,(54.14±6.11)mm in thickness,and(163.95±48.10)mL in volume in the normal group(P<0.01).The RI of the interlobar artery and segmental artery in the DGF group were 0.75±0.18 and 0.75±0.16,respectively,which were significantly higher than 0.58±0.07 and 0.61±0.08 in the normal group(P<0.01).The contrast-enhanced ultrasound parameters△I and AUC of patients in the DGF group

关 键 词：超声 超声造影 移植肾 延迟恢复 肾功能 

分 类 号：R445[医药卫生—影像医学与核医学]