超声造影定量评估大动脉炎性肾动脉炎患者肾皮质血流灌注的价值研究
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北京医院

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北京医院临床研究121工程(BJ-2018-198);中国医学科学院中央级公益性科研院所基本科研业务费项目(2019PT320012)


Assessment of renal cortical perfusion in patients with Takayasu arteritis-induced renal arteritis using contrast-enhanced ultrasound quantitative analysis
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Beijing Hospital Clinical Research 121 Project (BJ-2018-198);Basic Research Project of the Central Academy of Medical Sciences of China(2019PT320012)

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    摘要:

    目的 探讨超声造影(CEUS)定量分析技术评价大动脉炎性肾动脉炎(TARA)患者肾皮质血流灌注情况的应用价值。方法 回顾性研究。选取2017年7月至2019年12月于北京医院临床确诊为TARA的患者21例,另入选22例对照组。以分肾为研究对象,两组共86个肾脏。应用超声造影定量分析技术获取各研究对象分肾皮质血流灌注时间-强度曲线(TIC)及相关参数,包括曲线下面积(AUC)、上升支斜率(A)、峰值强度(PI)、达峰时间(TTP)和平均渡越时间(MTT)。比较两组研究对象分肾皮质血流灌注参数的差异,并分析各参数与肾小球滤过率(GFR)之间相关性。结果 经CTA或DSA证实,TARA组42支肾动脉中26支存在管腔狭窄,为患侧肾;16支无管腔狭窄,为健侧肾。与对照组相比,TARA组患侧肾TIC曲线各参数中:AUC减小、A减小、PI降低、TTP及MTT延长,均差异显著(P均<0.05)。此外,TARA组健侧肾的灌注参数A明显小于对照组、TTP较对照组明显增大(P均<0.05)。AUC、A、PI与GFR呈正相关(r=0.755、0.743、0.695,P<0.05),TTP和MTT与GFR呈负相关(r=-0.707、-0.731,P<0.05)。结论CEUS定量分析可准确评估TARA患者肾皮质血流灌注状态,其定量灌注参数与分肾功能相关性良好。

    Abstract:

    Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in quantifying renal cortical perfusion in patients with Takayasu arteritis-induced renal arteritis (TARA). Methods This is a retrospective study. 21 patients diagnosed with TARA, who were admitted in Beijing Hospital during July 2017 and December 2019, were enrolled. 22 subjects without kidney diseases or cardiovascular diseases were enrolled as a control group. 86 kidneys in two groups were analyzed. CEUS were performed to all subjects to quantitatively analyze renal cortical perfusion, then generating a time-intensity curve (TIC) and related parameters, including the area under the curve (AUC), the slope rate of ascending curve (A), the peak intensity (PI), the time to peak intensity (TTP) and the mean transit time (MTT). Analyze the differences of parameters mentioned above between the TARA group and the control group. The relationships between perfusion parameters and glomerular filtration rate (GFR) were also analyzed. Results Confirmed by CTA or DSA, 26 kidneys with renal artery stenosis in the TARA group were defined as the affected side. The other 16 kidneys free from renal artery stenosis were defined as the healthy side. The TIC parameters of the affected kidneys in TARA patients were significantly different from the control group. To be specifically, AUC, A, PI were notably lower while TTP and MTT were significantly prolonged in the TARA group (all P<0.05). In addition, the perfusion parameter A in TARA healthy kidneys was lower than control group while TTP was prolonged. AUC, A, PI showed positive correlations with GFR (P<0.05), while correlations between TTP, MTT and GFR were negative (P<0.05). Conclusion CEUS can quantitatively assess renal cortical perfusion in TARA patients, and the perfusion parameters showed strong correlations with GFR.

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李孟璞,任俊红,马娜,王思宇,孙由静,张玥伟,纪献浦,郭发金.超声造影定量评估大动脉炎性肾动脉炎患者肾皮质血流灌注的价值研究[J].临床超声医学杂志,2022,24(4):

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  • 收稿日期:2021-08-06
  • 最后修改日期:2022-03-15
  • 录用日期:2021-09-26
  • 在线发布日期: 2022-05-05
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