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纸质出版日期:2022,
网络出版日期:2022-12-30,
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张天生. 超声造影与超声定量指标对慢性肾肾脏疾病肾血流灌注的一致性[J]. 临床超声医学杂志, 2022,24(12).
zhangtiansheng. Comparison of contrast-enhanced ultrasound and quantitative ultrasound indicators to explore the consistency of renal blood perfusion in chronic renal disease[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(12).
张天生. 超声造影与超声定量指标对慢性肾肾脏疾病肾血流灌注的一致性[J]. 临床超声医学杂志, 2022,24(12). DOI:
zhangtiansheng. Comparison of contrast-enhanced ultrasound and quantitative ultrasound indicators to explore the consistency of renal blood perfusion in chronic renal disease[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(12). DOI:
【摘要】 目的:分析超声造影(CEUS)技术与彩色多普勒血流定量(CDFQ)技术对慢性肾脏疾病(CKD)肾血流灌注的一致性。方法:选我院2020年1月至2022年1月收入治疗的CKD患者62例,收集患者入院时相关实验室指标,根据美国NKF -K/DOQI工作组制订的 CKD 指南按照肾小球滤过率(eGFR)值将患者分为3组,轻度组(15例,eGFR≥60mL/min/1.73m2)、中度组(25例,59≤eGFR≤45mL/min/1.73m2)、重度组(22例,eGFR<45mL/min/1.73m2)。所有患者均行彩色多普勒血流显像(CDFI)检查,获得相关超声定量指标[血管指数(VI)、血流指数(FI)、血管血流指数(VFI)]。行超声造影检查获得峰值强度(DPI)、达峰时间(TTP)及曲线下面积(AUC)等的时间-强度曲线(TIC)参数。分析CEUS与超声定量指标评估肾血流灌注一致性。结果:轻度组VI、FI、VFI大于中度组、重度组,中度组VI、FI、VFI大于重度组,差异有统计学意义(P<0.05);轻度组DPI、AUC大于中度组、重度组,中度组DPI、AUC大于重度组;轻度组TTP小于中度组、重度组,中度组TTP小于重度组,差异有统计学意义(P<0.05);VI、FI、VFI、DPI、AUC均互为正相关性,且均与TTP呈负相关性(P<0.05);CEUS与超声定量指标评估轻度组、中度组肾血流灌注减少一致性尚可(P<0.05),评估重度组肾血流灌注减少一致性较好(Kappa 值=0.831,P<0.05)。结论:CDFQ与CEUS评估CKD患者肾血流灌注具有一致性,且评估eGFR<45mL/min/1.73m患者时,一致性最好,可用CDFQ替代CEUS对实施无创检测与肾血流灌注评估。
【Abstract】 Objective: To analyze the consistency of contrast-enhanced ultrasound (CEUS) and color Doppler flow quantification (CDFQ) in renal blood perfusion in chronic kidney disease (CKD).Methods: 62 CKD patients admitted to our hospital from January 2020 to January 2022 were selected
and relevant laboratory indicators were collected at the time of admission. According to the CKD guidelines formulated by the NKF-K/DOQI working group of the United States
patients were divided into three groups according to the glomerular filtration rate (eGFR) value: mild group (15 cases
eGFR≥60mL/min/1.73m2)
moderate group (25 cases
59≤eGFR ≤45mL/min/1.73m2)
and severe group (22 cases
eGFR<45mL/min/1.73m2). All patients were examined by color Doppler flow imaging (CDFI) to obtain relevant ultrasonic quantitative indicators [vascular index (VI)
blood flow index (FI)
vascular blood flow index (VFI)]. Time intensity curve (TIC) parameters such as peak intensity (DPI)
time to peak (TTP) and area under the curve (AUC) were obtained by contrast-enhanced ultrasound. The consistency of renal blood flow perfusion evaluated by CEUS and ultrasonic quantitative indexes was analyzed. Results: VF and II in mild group were higher than those in moderate group and severe group
and VF and II in moderate group were higher than those in severe group
with significant difference (P<0.05); DPI and AUC in mild group were higher than those in moderate group and severe group
and DPI and AUC in moderate group were higher than those in severe group; TTP in mild group was less than that in moderate group and severe group
and TTP in moderate group was less than that in severe group
with significant difference (P<0.05); FI
VI
VFI
DPI and AUC were all positively correlated with each other and negatively correlated with TTP (P<0.05); The consistency between CEUS and ultrasound quantitative indexes in evaluating the decrease of renal blood flow perfusion in mild and moderate groups was acceptable (P<0.05)
and the consistency in evaluating the decrease of renal blood flow perfusion in severe group was better (kappa value =0.831
P<0.05). Conclusion: The consistency of ultrasound quantitative indexes and CEUS parameters in evaluating renal blood flow perfusion in CKD patients is acceptable
and the consistency is the best when evaluating patients with eGFR<45mL/min/1.73m2.
超声造影超声定量指标慢性肾肾脏疾病肾血流灌
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