超声造影定量评价兔急性肾功能衰竭肾皮质血流灌注变化情况

摘要

目的 探讨超声造影定量技术评价早期兔急性肾功能衰竭肾皮质血流灌注变化的应用价值.方法 16只健康家兔于后腿多点肌肉注射50%甘油(12~15 ml/kg),建立兔急性肾功能衰竭模型,分别在注射甘油前和注射甘油后24 h测量血肌酐、尿素氮水平,再行超声造影检查,应用Q-LAB软件对时间-强度曲线(TIC)进行分析并比较注射甘油前后造影参数,包括造影剂始增时间(AT)、达峰时间(TTP)、峰值强度(A)、曲线上升支斜率(β)及曲线下面积(AUC).结果 16只兔均成功建立兔急性肾功能衰竭模型.注射甘油前兔肾皮质A和β值分别为(17.24±10.31)dB和(5.24±2.10)dB/s,明显高于注射甘油后24 h[(7.32±4.81)dB、(1.62±1.20)dB/s],差异均有统计学意义(均P<0.05).注射甘油前兔肾皮质TTP和AUC值分别为(2.48±1.81)s和(325.27±121.60)dBs,明显低于注射甘油后24 h[(6.10±3.41)s、(655.39±271.80)dBs],差异均有统计学意义(均P<0.05).注射甘油前和注射甘油后24 h AT、血肌酐、尿素氮、肾段动脉阻力指数及收缩期峰值流速比较,差异均无统计学意义.结论 超声造影定量技术能较早并有效地反映兔急性肾功能衰竭肾皮质的血流灌注情况,较血肌酐、尿素氮指标更敏感,有助于对兔急性肾功能衰竭的早期诊断,具有一定的应用价值.%Objective To explone the application value of contrast-enhanced ultrasound(CEUS) in quantitative evaluation of renal cortical and medullary perfusion in acute renal failure(ARF) in rabbits.Methods Rabbit ARF models were established with intramuscular 50%glycerin (12~15 ml/kg) injection into 16 rabbits'thighs and carried out CEUS examination before and after injection 24 h , then the perfusion time-intensity curve(TIC) by Q-LAB was analyzed . The parameters including arrival time(AT),time to peak intensity(TTP),amplitude of peak intensity(A),slope rate of TIC(β) and area under the curve(AUC).Results ARF model was successfully established in all 16 rabbits.The values of A and β of renal cortex before injection were(17.24±10.31)dB and(5.24±2.10)dB/s respectively,which were significantly higher than those after injection 24 h [(7.32±4.81)dB and(1.62±1.20)dB/s],there were significant differences(all P<0.05).The values of TTP and AUC of renal cortex before injection were(2.48 ±1.81)s and(325.27 ±121.60)dBs respectively,which were significantly lower than those after injection 24 h[(6.10±3.41)s and(655.39±271.80)dBs],there were significant differences(all P<0.05).Compared before injection,the difference of AT,serum urea nitrogen,serum creatinine,resistance index and peak systolic velocity after injection 24 h were not significant.Conclusion The CEUS quantitative technology can effectively reflect the condition of cortical and medullary perfusion in acute renal failure in rabbits,which is more sensitive than serum urea nitrogen and serum creatinine.It facilitates the early diagnosis of acute renal failure and has certain application value.