彩色多普勒超声、三维血管容积显像及超声造影在慢性移植物肾病中的对比研究

目的 探讨彩色多普勒超声、三维血管容积显像和超声造影在监测慢性移植物肾病(CAN)中的应用价值.方法 对89例移植肾患者分别进行彩色多普勒超声、三维血管容积显像和超声造影检查,应用受试者工作特征(ROC)曲线比较三者评价CAN的准确性、敏感性和特异性.结果 与稳定组相比,CAN组的阻力指数及搏动指数均升高(P<0.05);血管指数(VI)、血流指数(FI)、血管血流指数(VFI)均降低(P<0.05),灰阶指数(MG)升高(P<0.05);皮质、髓质上升时间(RT)、到达时间(AT)、达峰时间(TTP)、平均通过时间(mTT)均延长(P<0.05).ROC曲线下面积比较:VI、FI、VFI大于MG、体积(P<0.05);RT皮大于AT皮、TTP皮、mrrr皮、QOF皮、RT髓、AT髓、,TTP髓、mTT髓、QOF髓(P<0.05);RT皮、VI、FI及VFI均大于阻力指数(P<0.05).以RT皮≥7.40s,VI≤24.03%、FI≤45.85%和VFI≤11.19%诊断CAN的敏感性分别为86.7%、86.7%、84.4%、88.9%,特异性分别为75.0%、75.0%、75.0%、79.5%,阳性预测值分别为86.8%、84.6%、82.5%、87.5%.结论 超声造影和三维血管容积显像可以更好评价移植肾的血流灌注,较彩色多普勒超声更有诊断意义.

Comparison study of color Doppler,three-dimensional vascular volume imaging and contrast-enhanced ultrasound in chronic allograft nephropathy

Objective To discuss the clinical application value of color Doppler, three-dimensional vascular volume imaging and contrast - enhanced ultrasound in chronic allograft nephropathy （ CAN ）. Methods Eighty - nine renal allograft patients underwent color Doppler, three-dimensional vascular volume imaging and contrast-enhanced uhrasound examination. The receiver operating characteristic （ROC）curve was applied to analyze the accuracy, sensitivity and specificity of lhe parameters in evaluating CAN. Results Compared with the group with stable renal function, the parameters in CAN group changed as follows： RI and PI were increased（P〈0.05 ） ; VI, FI and VFI were decreased（ P〈0.05 ）, MG was increased （ P〈 0. 05 ） ; RT, AT, TTP and mYI＇ in the cortex and medulla were extended（ P〈0.05 ）. The results of ROC showed ： the area under the ROC curve of VI, FI and VFI was higher than that of MG and V （P〈0.05） ; the area under the ROC crave of RT in the cortex was higher than that of AT, TTP, mTT, QOF in the cortex and AT, TTP, mTT, QOF in the medulla（P〈0.05） ;the area under the ROC curve of RT, VI,FI and VFI in the cortex were higher than RI （P〈0.05）. Conclusion Compared with color Doppler ultrasound, contrast-enhanced ultrasound and three-dimensional vascular volume can evaluate the blood tlow perfusion of transplantation kindey more effective.