Contrast-enhanced ultrasound with SonoVue could accurately assess the renal microvascular perfusion in diabetic kidney damage
Contrast-enhanced ultrasound with SonoVue could accurately assess the renal microvascular perfusion in diabetic kidney damage
复制标题
SonoVue 超声造影可准确评估糖尿病肾损伤中的肾微血管灌注
DOI：
10.1093/ndt/gfr789
复制
发表时间：
2012-07-01
影响因子：
6.1
通讯作者：
Peng, Ai
中科院分区：
文献类型：
--
作者：
Ma, Fang;Cang, Yanqin;Peng, Ai
为探讨实时灰阶超声造影(CEUS)评价糖尿病肾脏微血管血流灌注的临床意义，将年龄62.5±7.2岁的33例糖尿病患者分为慢性肾脏病(CKD)I、II期(19例)和CKD IV、V期(B组)，并选择21例健康成人作为对照组。采用声诺维超声造影技术对肾皮质进行实时动态成像。选择拟合度指数为85%的中断时间-强度曲线(TICS)分析基本强度、强度增量(A1)、到达时间(AT)、达峰时间(TTP)、平均通过时间、峰值强度(PI)和曲线下总面积(AUC)。(2)各组肾皮质TIC呈不对称单峰曲线，有明显的上升斜率、峰值斜率和下降斜率。上坡陡峭，下坡平坦。但A组和B组的上升斜率较对照组平坦。(3)与对照组相比，A、B两组AT、TTP均显著延长，A1、PI显著降低(P<0.05)。A组AUC呈上升趋势，而B组上升坡下面积(AUC1)、下降坡下面积(AUC2)和AUC均下降(P<0.05)。(4)AUC与肾小球滤过率呈正相关(r 0.472，P0.01)，而TTP与肾小球滤过率相关性不好(r 0.262，P 0.177)。PI、TTP、AUC可作为早期和晚期糖尿病患者肾微血管病变的诊断指标。超声造影是一种安全、非侵入性、简便的检测肾脏微血管灌注缺陷严重程度的技术。
The aim of this study was to investigate the clinical significance of real-time gray-scale contrast-enhanced ultrasound (CEUS) through evaluating renal microvascular perfusion in diabetic kidney damage.Diabetic patients (aged: 62.5 7.2, n 33) were divided into Group A with chronic kidney disease (CKD) Stages I and II (n 19) and Group B (n 14) with CKD Stages IV and V. Twenty-one healthy adults were selected as control group. The real-time and dynamic imaging from renal cortex was performed using contrast-enhanced ultrasound with SonoVue. The outage time-intensity curves (TICs) with 85% goodness-of-fit index were chosen for the analysis of basic intensity, intensity increment (A1), arriving time (AT), time to peak (TTP), mean transit time, peak intensity (PI) and total area under the curve (AUC).(i) After intravenous injection of a contrast agent, the renal artery, cortex, pyramid and renal vein were clearly displayed in sequence. (ii) TIC of renal cortical Perfusion in all groups showed an asymmetrical single-peak curve, which has an obvious ascending slope, peak and descending slope. The ascending slope was steep, whereas the descending slope was flat. However, the ascending slope in Group A and B was flatter than that in the control group. (iii) Compared to the control group, AT and TTP were all markedly prolonged but A1 and PI were significantly decreased in Group A and B (P 0.05). In Group A, the AUC had a trend of increase; however, the area under the ascending slope (AUC1), area under the descending slope (AUC2) and AUC were all decreased in Group B (P 0.05). (iv) AUC positively correlated with glomerular filtration rate (GFR) (r 0.472, P 0.01), but TTP did not correlate well with GFR (r 0.262, P 0.177).CEUS could accurately assess renal microvascular perfusion in a real-time and dynamic manner. PI, TTP and AUC could be used for the diagnosis of the renal microvascular damage in early and late stage diabetic patients. CEUS is a safe, noninvasive and simple technique to detect the severity of kidney microvascular perfusion deficits.