声学造影与彩色多普勒能量图定量分析诊断移植肾急性排斥反应

目的 探讨声学造影结合彩色多普勒能量图定量分析对移植肾急性排斥反应的诊断价值。方法 运用电子微量注射泵对41例肾移植患者外周静脉匀速注入（2min内）声学造影剂半乳糖－棕榈酸2.5g，利用电子计算机彩色直方图软件测定术后正常组和急性排斥反应组移植肾横切面积与其内血流显示面积之比（BFAR），以比较两组移植肾血流灌注的定量分布情况及造影历时时间的差异。结果 造影后排斥组和正常组移植肾内血流显像均较造影前增强（P＜0．05），但排斥组BFAR的增加值为20．2％，明显低于正常组的29．8％（P＜0．05）；排斥组72．7％的病例BFAR＜70％，无一例BFAR＞90％；正常组42．1％的病例BFAR＞90％，无一例BFAR＜70％；造影前后比较，两组的BFAR重叠率从56．1％降至41．5％；两组的血流增强开始时间和峰值时间的差异无显著性（P＞0．05），而排斥组造影持续时间为534s，正常组为346s，差异有显著性（P＜0．01）。结论 声学造影结合彩色多普勒能量图定量分析为肾移植术后急性排斥反应的诊断提供了较为可靠、客观的影像学依据。

Diagnosis of acute rejection in renal allografts using Levovist quantitative analysis in color Doppler energy

Objective To study the diagnostic significance of Galagtose and palmitic acid (Levovist) quantitative analysis in color Doppler energy (CDE) for acute rejection (AR) in renal allografts.Methods Forty one patients with renal graft, including 19 cases of normal post operation (NP) and 22 cases of acute reject (AR), received even injection of 2.5?g Levovist via peripheral vein over 2 min under control of electronic pump. Using histogram software, blow flow area ratio (BFAR) of transplanted kidney was measured and taken as a quantitative parameter for evaluating blood flow imaging status of transplanted kidney. Results Levovist remarkably enhanced the transplanted renal blood flow imaging in either normal group or acute rejection group. The enhancement of BFAR in AR group was 20.2% , significantly lower than that in NP ( 29.8% , P < 0.05 ). In AR group, BFAR in 72.7% (16/22) of the cases was <70% and none was >90%; In NP group, BFAR in 42.1% (8/19) of the cases was >90% and none was <70%. The overlapping rate of BFAR in two groups was lowered from 56.1% to 41.5% as compared pre Levovist with post Levovist. Analysis of its changes with time revealed that the lasting time of enhancement was 534 s in AR group and 346 s in NP group, respectively ( P < 0.05 ).Conclusion Levovist quantitative analysis in color Doppler energy might provide the reliable and objective evidence for the diagnosis of AR following renal transplantation.