超声造影定量评估肾脏血流灌注在经皮肾镜取石术中的应用价值  

Quantitative evaluation of renal blood perfusion by contrast-enhanced ultrasound in percutaneous nephrolithotomy

作　　者：田霁松 李寿鹏 麦海星[3] 沈东来[3] 王威[3] 陈海瑞 张旭[3] 李秋洋[2] 罗渝昆 Tian Jisong;Li Shoupeng;Mai Hairing;Shen Donglai;Wang Wei;Chen Hairui;Zhang Xu;Li Qiuyang;Luo Yukun(The Second Clinical Medical School,Lanzhou Univeisity,Lanzhou 730030,China;Department of Ultrasound,the First Medical Center of PLA General Hospital,Beijing 100853,China;Department of Urology,the Third Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]解放军总医院第一医学中心超声诊断科,北京100853 [3]解放军总医院第三医学中心泌尿外科医学部,北京100039

出　　处：《微创泌尿外科杂志》2024年第4期235-239,共5页Journal of Minimally Invasive Urology

基　　金：国家自然科学基金面上项目(82371985);军队后勤保障部科研专项课题(21BJZ13)。

摘　　要：目的:探讨超声造影(CEUS)定量评估肾脏血流灌注在经皮肾镜取石术(PCNL)中的应用价值。方法:前瞻性纳入2024年1月至2024年4月在解放军总医院第一医学中心进行双重超声造影引导的PCNL的肾结石患者21例,均于术前2 d、术后2周进行CEUS检查。比较PCNL前结石压迫区肾皮质与非结石压迫区肾皮质造影参数[峰值强度(PI)、到达时间(AT)、达峰时间(TTP)、曲线下面积(AUC)],PCNL前后结石压迫区肾皮质造影参数,以及PCNL后结石压迫区肾皮质与非结石压迫区肾皮质造影参数的差异。统计学方法采用配对样本t检验、配对样本Wilcoxon符号秩检验分析等。结果:PCNL前,结石压迫区肾皮质PI、AUC明显低于非结石压迫区,AT、TTP高于非结石压迫区,差异均有统计学意义(均P<0.05)。PCNL后,结石压迫区肾皮质PI、AUC均明显高于术前,差异有统计学意义(均P<0.001),AT、TTP与术前比较差异无统计学意义(P>0.05)。PCNL后结石压迫区肾皮质PI、AUC与非结石压迫区肾皮质比较差异无统计学意义(P>0.05),AT、TTP与非结石压迫区肾皮质比较差异有统计学意义(P<0.05)。结论:PCNL解除肾结石后能明显改善肾内血流灌注情况,CEUS在评估局部肾功能、PCNL疗效和术后肾功能随访中具有重要的临床意义。Objective:To investigate the value of quantitative evaluation of renal blood perfusion by contrast-enhanced ultrasound(CEUS)in percutaneous nephrolithotomy(PCNL).Methods:A total of 21 renal stone patients with PCNL who underwent double contrastus-guided PCNL at the First Medical Center of the PLA General Hospital from January 2024 to April 2024 were prospectively included.CEUS examinations were performed 2 days before surgery and 2 weeks after surgery.The differences of imaging parameters[peak intensity(PI),time of arrival(AT),time of peak arrival(TTP)and area under the curve(AUC)]between the renal cortex in stone compression area and non-stone compression area before PCNL,the renal cortical angiography parameters in stone compression area before and after PCNL,and the contrast parameters of renal cortex in stone compression area and non-stone compression area after PCNL were compared.Statistical methods were analyzed by Matched samples t-test and paired samples Wilcoxon signed rank test,et al.Results:Before PCNL,the PI and AUC of renal cortex in the stone compression area were significantly lower than those in the non-stone compression area,AT and TTP were higher than those in noncalculus compression area,and the differences were statistically significant(all P<0.05).After PCNL,the PI and AUC of renal cortex were significantly higher than those before operation,with statistical significances(all P<0.001),but there was no significant difference in the AT or TTP compared with those before operation(P>0.05).There was no significant difference in the PI or AUC of the renal cortex in the stone compression area after PCNL compared with that in the non-stone compression area(P>0.05),the differences of renal cortex AT and TTP in stone compression area were statistically significant compared with that in non-stone compression area(all P<0.05).Conclusion:PCNL can significantly improve the intrarenal blood perfusion after the removal of kidney stones.CEUS has important clinical significance in the evaluation of local renal

关 键 词：超声造影 经皮肾镜取石术 血流灌注 

分 类 号：R692.4[医药卫生—泌尿科学]