微血管成像联合Qpack定量分析技术评估慢性肾脏病患者肾皮质区血流灌注的价值  

Microvascular imaging combined with Qpack quantitative analysis for assessment of blood perfusion in the renal cortex of patients with chronic kidney disease

作　　者：王丽萍 徐磊[3] 蒋天安[1] 强嘉璘 Wang Liping;Xu Lei;Jiang Tian'an;Qiang Jialin(Department of Ultrasound Medicine,the First Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,China;Department of Ultrasound Medicine,Zhejiang Qingchun Hospital,Hangzhou 310016,China;Department of Ultrasound Medicine,Jinhua Municipal Central Hospital,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属第一医院超声医学科,杭州310003 [2]浙江省青春医院超声科,杭州310016 [3]金华市中心医院超声科,浙江金华321000

出　　处：《中华医学超声杂志（电子版）》2023年第3期292-296,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声微血管成像联合Qpack定量分析技术在评估慢性肾脏病(CKD)患者肾皮质区血流灌注中的应用价值。方法选择浙江大学医学院附属第一医院肾内科2020年3月至8月收治的CKD患者92例,并对患者进行CKD 1-5期划分;另选取同期健康志愿者25名为正常对照组。采用χ^(2)检验及t检验比较CKD组及正常对照组间性别、年龄和体质量指数的差异。对所有受检者双侧肾皮质区进行微血管成像,通过Qpack定量分析获得肾皮质区血流信号峰值;采用t检验比较双侧肾相邻CKD分期组间峰值的差异;采用Pearson相关分析CKD患者双侧肾峰值与肾小球滤过率(GFR)及血肌酐间的相关性。结果正常对照组与CKD组间性别、年龄及体质量指数比较,差异均无统计学意义(P均>0.05)。CKD 1期患者左肾及右肾峰值均低于正常对照组[(64.67±9.19)%vs(78.63±6.78)%;(60.11±9.67)%vs(74.66±5.89)%],差异具有统计学意义(t=15.365、17.477,P均<0.001)。随着CKD分期增加,其双肾峰值依次降低[左肾CKD 2-5期:(57.05±9.52)%、(46.80±9.29)%、(35.73±6.44)%、(5.64±3.45)%;右肾CKD 2-5期:(55.19±10.16)%、(47.09±8.02)%、(33.90±6.29)%、(6.67±3.98)%],左肾及右肾CKD 2期峰值与CKD1期比较,差异无统计学意义(P>0.05),而CKD 2-5期的相邻分期峰值比较,差异均具有统计学意义(CKD 3期vs CKD 2期:t=-3.176、-2.583,P=0.003、0.015;CKD 4期vs CKD 3期:t=3.953、5.235,P均<0.001;CKD 5期vs CKD 4期:t=-19.476、-17.024,P均<0.001)。CKD患者双肾峰值与GFR呈正相关(r=0.843、0.825,P均<0.001),与血肌酐呈负相关(r=-0.806、-0.808,P均<0.001)。结论微血管成像联合Qpack定量分析能反映CKD患者肾皮质血流灌注情况。Objective To evaluate the value of ultrasound microvascular imaging(MicroV)combined with Qpack quantitative analysis in assessing blood perfusion in the renal cortex of patients with chronic kidney disease(CKD).Methods Ninety-two patients with CKD who were admitted to the Department of Nephrology,the First Affiliated Hospital of Zhejiang University School of Medicine from March 2020 to August 2020 were selected and classified into five subgroups based on CDK stage(stages 1-5).Twenty-five healthy volunteers were selected as a normal control group.Theχ^(2) and t-tests were used to compare the difference of gender,age and body mess index between the CKD and normal control groups.Microvascular imaging was performed on both sides of the renal cortex of all subjects,and the peak value of blood flow signal was analyzed by quantitative Qpack method.The t-test was performed to compare the peak values of blood flow signal between adjacent CKD stages in both sides of the renal cortex.Pearson correlation method was used to analyze the correlation of the peak value of blood flow signal with glomerular filtration rate(GFR)and creatinine.Results There was no difference in age,gender,or body mass index between the CKD and normal control groups(P>0.05).The peak values of blood flow signal in the left and right kidneys were significantly lower in the CKD1 group than in the control group[(64.67±9.19)%vs(78.63±6.78)%,t=15.365,P<0.001;(60.11±9.67)%vs(74.66±5.89)%),t=17.477,P<0.001].The peak values of blood flow signal in the bilateral renal cortex decreased with the increase of CKD stage[CKD stages 2-5 in left renal cortex:(57.05±9.52)%,(46.80±9.29)%,(35.73±6.44)%,(5.64±3.45)%;CKD stages 2-5 in right renal cortex:(55.19±10.16)%,(47.09±8.02)%,(33.90±6.29)%,(6.67±3.98)%].There was no significant difference in the peak values of blood flow signal in the left and right kidneys between the CKD stage 2 group and CKD stage 1 group(P>0.05),but there were significant differences between adjacent stages of CKD stages 2-5(stage 3 v

关 键 词：超声 微血管成像 Qpack 慢性肾脏病 峰值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学]