摘要
目的探讨超声造影定量分析技术在慢性肾功能不全（CKD）患者肾脏功能评价中的应用价值。方法根据美国NKF-K／DOQI工作组的“慢性肾脏病”标准将50例CKD患者分为1-5期，每期10例；另选健康正常对照组10例。所有受检者均进行双肾实时超声造影检查，用QLAB定量分析软件进行定量分析，获取时间一强度曲线（TIC）及相关灌注参数，包括曲线下面积（AUC）、达峰时间（TTP）、峰值强度（DPI）、曲线上升支斜率（A）、曲线下降支斜率（a），分析各灌注参数在CKD不同分期中的差异，以及各参数与肾功能指标肾小球滤过率（GFR）的相关性。结果与正常对照组比较，CKD组TIC曲线上升缓慢，随着CKD严重程度的增加，其曲线上升支斜率亦逐级增大，达峰时间逐级延长，峰值强度逐级降低，曲线形态圆钝。1-5期CKD组与正常对照组比较AUC升高、DPI降低，差异均有统计学意义，2-5期CKD组与正常对照组比较，ITP延长、A增大，差异有统计学意义，仪在正常对照组及1—5期CKD组间差异无统计学意义。AUC、DPI、A与GFR呈正相关（枷．782、0．698、0．630，P〈O．05），DPI与GFR呈负相关（R=-0．636，P〈0．05），AUC与GFR相关性最高。结论肾脏实时超声造影技术能准确、安全、简便、高效地评价CKD患者的肾脏功能，且能反映不同病程CKD的严重程度。
Objective To investigate the contrast-enhanced ultrasound quantitative analysis techniques used in the evaluation of renal function in patients with chronic renal dysfunction. Methods Fifty cases of patients with CKD, CKD 1-5 stages were confirmed according to the U.S. NKF-K/DOQ[ Working Group standard, each stage has 10 cases. 10 healthy cases as control group. All subjects underwent real-time enhanced ultrasound, then QLAB quantitative analysis software was used for quantitative analysis, time-density curve （TIC） and perfusion parameters AUC, DPI, TIP, A,and cL were acquired. The differences of perfusion parameters in different CKD stages and relationship between perfusion parameters and GFR were analyzed. Results In CKD groups, renal cortex perfusion TIC curve showed slow ascending and descending shape compared with contrcol group. The perfusion parameters AUC, DPI showed significant difference in 1 ~5 stage. The perfusion parameters ＇ITP, A showed significant difference in 2-5 stage, the perfusion ol showed no significant difference in 1-5 stage. AUC, DPI, A showed positively correlation （r= 0.782,0.698,0.630, P〈0.05 ）, DPI showed negatively correlation with GFR （r =-0.636, P〈0.05 ）, the parameter AUC had a strong correlation with GFR. Conclusion Qualititative analysis of contrast-enhanced ultrasound can be used to assess the blood flow in renal cortex accurately and safely. The technique is useful to evaluate the renal function of CKD patients.
出处
《临床超声医学杂志》
2013年第9期612-615,共4页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
造影剂
肾功能
定量评价
Ultrasonography
Contrast agent
Renal function
Quality evaulation
