超声造影联合彩色多普勒血流定量技术对慢性肾脏疾病肾血流灌注的诊断价值  

Value of contrast-enhanced ultrasound combined with color Doppler flow quantification technology in the diagnosis of renal blood perfusion of chronic kidney disease

作　　者：张天生[1] 韩小军 曹芳芳[1] 罗金 胡登 ZHANG Tiansheng;HAN Xiaojun;CAO Fangfang;LUO Jin;HU Deng(Department of Urology,Mianyang Central Hospital,Sichuan 621000,China)

机构地区：[1]四川省绵阳市中心医院泌尿外科,621000

出　　处：《临床超声医学杂志》2022年第12期930-933,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声造影(CEUS)联合彩色多普勒血流定量(CDFQ)技术对慢性肾脏疾病(CKD)肾血流灌注的诊断价值,分析两种方法评估不同程度肾血流灌注的一致性。方法选我院收治的CKD患者62例,根据肾小球滤过率(eGFR)分为3组,轻度组15例(eGFR≥60 ml·min^(-1)·1.73 m^(-2))、中度组25例(eGFR 45~60 ml·min^(-1)·1.73 m^(-2))、重度组22例(eGFR<45 ml·min^(-1)·1.73 m^(-2))。各组均行CDFQ检查获得血管指数(VI)、血流指数(FI)、血管血流指数(VFI);超声造影检查获得峰值强度(PI)、达峰时间(TTP)及曲线下面积(AUC);比较各组上述参数的差异。分析CEUS与CDFQ评估不同程度肾血流灌注的一致性。结果CDFQ检查结果显示,各组VI、FI、VFI比较差异均有统计学意义(均P<0.05),轻、中、重度组VI、FI、VFI均依次降低,两两比较差异均有统计学意义(均P<0.05)。CEUS检查结果显示,各组PI、TTP、AUC比较差异均有统计学意义(均P<0.05),轻、中、重度组PI、AUC均依次降低,TTP依次升高,两两比较差异均有统计学意义(均P<0.05)。CEUS与CDFQ评估轻度组、中度组肾血流灌注降低的一致性一般(Kappa=0.737、0.733,均P<0.05),评估重度组肾血流灌注降低的一致性较好(Kappa=0.831,P<0.05)。结论CEUS联合CDFQ对CKD患者肾血流灌注具有较好的诊断价值,且CDFQ与CEUS评估eGFR<45 ml·min^(-1)·1.73 m^(-2)患者肾血流灌注的一致性较好。Objective To explore the value of contrast-enhanced ultrasound(CEUS)combined with color Doppler flow quantification(CDFQ)technology in the diagnosis of renal blood perfusion of chronic kidney disease(CKD),and to analyze the consistency of two methods in evaluating the different degree of renal blood perfusion.Methods Totally 62 CKD patients admitted to our hospital were selected,they were divided into 3 groups according to the glomerular filtration rate(eGFR),mild group 15 cases(eGFR≥60 ml·min^(-1)·1.73 m^(-2)),moderate group 25 cases(eGFR 45~60 ml·min^(-1)·1.73 m^(-2)),and severe group 22 cases(eGFR<45 ml·min-1·1.73 m^(-2)).All groups were examined by CDFQ,the vascular index(VI),blood flow index(FI),vascular blood flow index(VFI)were obtained.While peak intensity(PI),time to peak(TTP)and area under the curve(AUC)were obtained by CEUS.The differences of above parameters in each group were compared.The consistency of different degree of renal blood flow perfusion was evaluated by CEUS and CDFQ.Results The results of CDFQ showed that there were significant differences of VI,VF and VFI in all groups(all P<0.05),and VI,VF and VFI were gradually decreased in mild,moderate and severe group,there were significant differences(all P<0.05).The results of CEUS showed that there were significant differences of PI,TTP and AUC in all groups(all P<0.05),PI and AUC were gradually decreased in mild,moderate and severe group,while TTP was gradually increased,there were significant differences(all P<0.05).The consistency of CEUS and CDFQ in evaluating the decreasing of renal blood flow perfusion in mild and moderate groups was general(Kappa=0.737,0.733,both P<0.05),and the consistency in evaluating the decreasing of renal blood flow perfusion in severe group was good(Kappa=0.831,P<0.05).Conclusion CEUS combined with CDFQ has good value in the diagnosis of renal blood perfusion in CKD patients,and the two methods have good consistency in evaluating the renal blood perfusion in patients with eGFR<45 ml·min^(-1)·1.73 m^(-2).

关 键 词：超声检查 造影剂 彩色多普勒血流定量 肾脏疾病 慢性 肾血流灌注 

分 类 号：R445.1[医药卫生—影像医学与核医学]