| 摘要: |
| 目的 探讨彩色多普勒血流成像（Color doppler flow imaging，CDFI） 和超微血流显像（Super microvascular imaging，SMI）对慢性肾脏病（Chronic kidney disease，CKD）患者肾血流灌注改变的临床价值。方法 采用CDFI及SMI分别观察正常受检者和CKD1-5期患者双侧肾脏血流灌注情况，并对肾脏血流分布情况进行分级，检测CDFI与SMI对CKD患者肾血流灌注改变的评价效果，并比较SMI与CDFI对各级肾血管的显示能力。同时采用Spearman分析法，将CDFI、SMI血流灌注分级与CKD前三期临床分期进行相关性分析。结果 1.对照组与CKD1期、CKD2期的CDFI及SMI肾血流灌注分级两两比较差异均无统计学意义（P>0.01）。2.CDFI肾血流灌注显像中,CKD前三期肾血流灌注两两比较差异无统计学意义（P>0.01）；CKD4-5期与前三期比较差异有统计学意义（P<0.01）。3.SMI肾血流灌注显像中，CKD3期与CKD1期、CKD2期及 CKD4-5期之间差异有统计学意义（P<0.01），CKD4-5期与前三期比较差异有统计学意义（P<0.01）。4.随着CKD临床分期越高，SMI及CDFI的肾血流灌注分级均降低，且各期的SMI肾血流灌注分级均高于CDFI ，同时每组SMI检测出的高占比的血流分级均高于CDFI，差异均有统计学意义（P<0.05），SMI尤其对弓形动脉和小叶间动脉的显示更清晰。5.SMI肾血流灌注分级与CKD临床分期有较强相关关系（Rs为－0.657，P＜0.01）；CDFI肾血流灌注分级与CKD临床分期有中等相关关系（Rs为－0.419，P＜0.01）。结论 SMI可作为评价CKD肾血流灌注改变重要的影像方法，可有效协助临床对CKD患者的诊断、治疗及预后评估,具有重要临床应用价值 |
| 关键词: 慢性肾脏病 彩色多普勒血流成像 超微血流显像 血流灌注 |
| DOI： |
| 投稿时间：2021-07-18修订日期：2021-08-01 |
| 基金项目: |
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| Color Doppler and Superb Micro-vascular Imaging for Chronic Kidney Disease Renal Blood Perfusion |
| HU xiaoli,MING Zhiqiang,GU Peng,QU Xiping |
| (Zigong first people''s Hospital) |
| Abstract: |
| Objective To investigate the clinical value of color doppler flow imaging (CDFI) and super microvascular imaging (SMI) on renal perfusion changes in patients with chronic kidney disease (CKD).Methods CDFI and SMI were used to observe the bilateral renal perfusion in normal subjects (control group) and patients with CKD1-5 stage (case group), respectively, and to test the evaluation effect of CDFI and SMI on renal perfusion changes in CKD patients by grading the renal blood flow distribution, and to compare the ability of SMI to show the renal vasculature at all levels. Spearman analysis was also used to correlate the CDFI and SMI perfusion grading with the first three clinical stages of CKD.Results 1.The differences in CDFI and SMI renal perfusion grading between the control group and CKD1 and CKD2 stages were not statistically significant (P>0.01). 2. In CDFI renal perfusion imaging, the changes in renal perfusion in the first three stages of CKD were not significant, and the differences were not statistically significant (P>0.01); the differences between CKD4-5 stages and the first three stages were significant, and the differences were statistically significant (P<0.01). 3. The difference between CKD stage 3 and CKD1, CKD stage 2 and CKD stage 4-5 in SMI renal perfusion imaging was significant (P<0.01), and the difference between CKD stage 4-5 and the first three stages was significant (P<0.01). 4. With the higher clinical stage of CKD, the renal perfusion grade of both SMI and CDFI decreased, and the renal perfusion grade of SMI in each stage was higher than that of CDFI. while the flow grading of high occupancy ratio detected by SMI was higher than that of CDFI in each group,and the difference was statistically significant (P<0.05), and the SMI showed a clearer picture of the arcuate and interlobular arteries in particular. 5. There was a strong correlation between SMI renal perfusion grading and CKD clinical stage (Rs -0.657, P < 0.01); there was a moderate correlation between CDFI renal perfusion grading and CKD clinical stage (Rs -0.419, P < 0.01).Conclusion SMI can be used as an important imaging method to evaluate the renal perfusion changes in CKD, which can effectively assist in the diagnosis, treatment and prognosis of CKD patients, and has important clinical application valueand it is safe and reliable with strong follow-up. It is worthy of clinical promotion and application. |
| Key words: Chronic kidney disease Color doppler flow imaging Superb micro-vascular imaging Blood perfusion |
