目的 探讨超声造影（CEUS）定量分析对评估早期慢性肾脏疾病（CKD）血流灌注改变以及病变严重性的价值。方法 20例临床确诊CKD 1~3期患者纳入研究（病例组），同时以15例正常成年人为对照（对照组）。对所有受检者进行左肾皮质实时灰阶CEUS，比较两组受检者反映肾脉血流灌注的时间-强度曲线（TIC）参数差异。将两组受检者差异有统计学意义的TIC参数与病例组估算肾小球滤过率（eGFR）、尿蛋白定量与胱抑素C进行相关性分析。结果 病例组与对照组比较，TIC的上升时间（rise time,RT)、曲线下面积（area under the curve,AUC）、峰值半降时间（time from peak to one half）、达峰时间（time to peak,TTP）的差异有统计学意义（P<0.05）。eGFR与上述4个TIC参数均呈负相关（P均<0.05），尿蛋白定量与其中3个TIC参数（除外RT）、胱抑素C与4个TIC参数均呈正相关（P均<0.05）。结论 超声造影定量分析数据能反映早期肾脏疾病患者血流灌注与正常人的不同，并与反映肾脏损害的实验室数据相关性较高，为评估肾脏疾病患者疾病程度提供了影像学的定量证据。
英文摘要:
Objective To determine the value of contrast-enhanced ultrasound (CEUS) for assessing renal blood perfusion changes and severity of early chronic kidney diseases (CKD). Methods The study included 20 patients with clinical diagnosed CKD (grade 1-3) (case group) and fifteen normal adults (control group). They were given real time CEUS, assessing left renal cortex blood perfusion. We identified the time-intensity curve (TIC) parameters that could differentiate participants between the two groups, and tested their correlations with glomerular filtration rate (eGFR), quantity of urinary protein and cystatin C. Results Significant differences were found in rise time (RT), area under the curve (AUC), time from peak to one half, and time to peak (TTP) between the two groups (P< 0.05). eGFR was negatively correlated with all of the four TIC parameters (P<0.05). The quantity of urinary protein was positively correlated with three of the four TIC parameters (except RT). Cystatin C was positively correlated with all of the four TIC parameters (P<0.05). Conclusion CEUS can detect changes of blood flow perfusion in patients with early chronic kidney disease. The perfusion parameters are associated with laboratory results reflecting renal damages.
