肾脏血流灌注的评估:造影增强彩色多普勒时间-强度曲线分析

背景超声评价肾脏功能主要通过测量较粗大的肾脏各级动脉的血流参数或肾切面内动脉彩色血流面积所占的比例来推断,误差较大.目的应用超声仪器随机配置的彩色多普勒时间-强度曲线软件评价肾脏血流灌注情况.设计动物实验观察.单位广州市第一人民医院功能检查科.材料实验于1999-01/2000-04在广州军区广州总医院动物实验室完成,选择8只健康新西兰兔,雌雄各4只,体质量2.5～3.5 kg.观察肾脏16个.声学造影剂为全氟显,主要成分为声振白蛋白的微泡,微泡内有一定浓度的全氟丙烷气体.方法兔外周静脉团注造影剂全氟显后用彩色多普勒能量图、彩色多普勒血流显像和彩色多普勒能量谐波成像连续采集肾脏彩色血流图像,随机配置软件显示时间-强度曲线.主要观察指标造影增强肾脏血流灌注时间-强度曲线的形态.结果进入结果分析8只家兔.肾脏血流造影增强的时间-强度曲线呈单峰状,上升支陡直,下降支平缓.调节时间轴上的感兴趣线可作定量分析,回放显示注射造影剂后对应某一时刻的造影增强的彩色多普勒图像.结论造影增强彩色多普勒血流显像和彩色多普勒能量图的时间-强度曲线能有效的观察肾脏血流灌注特征,既可显示整个肾脏的血流灌注情况,也用于观察低血流灌注区域,发现病灶进一步绘制肾功能图.

Evaluation of renal blood perfusion: analysis of time-density curve with contrast-enhanced color Doppler

BACKGROUND:By using ultrasound examination, renal function was conventionally assessed through measuring the blood flow parameters of large renal arteries in all levels and the rate of the color flow area in arter ies on the cross section of kidneys, in which method great errors have been induced.OBJECTIVE: This study was designed to assess the renal blood perfusion with use of the image analysis software package in the color Doppler system.DESIGN: It was an experimental study on animals.SETTING: This study was conducted in the Department of Functional Examination of Guangzhou First People' s Hospital.MATERIALS: The study had been accomplished at the Animal Laboratory of the General Hospital of Guangzhou Military Area Command of Chinese PLA from January 1999 to Aprial 2000. Eight healthy New Zealand rabbits were selected, 4 females and 4 males and weighing 2.5-3.5 kg.Sixteen kidneys of them were examined. A self-made contrast medium, with prevailing ingredient of albumin shelled and CsF8 gas-filled microbubbles,was used in this study.METHODS: After intravenous bolus injection of a fluorocarbon contrast medium, a color Doppler energy mapping, a color flow mapping and a power Doppler harmonic imaging of renal blood flow were collected successively and a time-density curve were created with system's standard software.MAIN OUTCOME MEASURES: The time-density curve of renal blood perfusion with contrast-enhanced color Doppler was a main outcome measurement in the study.RESULTS: All of the 8 rabbits entered the analysis procedure. The contrast-enhanced time-density curve of renal blood perfusion was singlepeaked, with a rapid incline and a subsequent slow decline. Quantitative analysis of interested sections could be performed by replaying the corresponding contrast-enhanced color Doppler images at a certain time after injection.CONCLUSION: The time-density curve of color flow mapping and color Doppler energy mapping is capable of reflecting the features of renal blood perfusion effectively. It can display not only the general renal perfusion but also the segmental regions with low perfusion, and thus to delineate the functional lesions in the kidneys.