超声造影和声学密度定量对移植肾动脉狭窄的研究

目的探讨使用超声造影和声学密度定量技术在观察移植肾动脉主干不同狭窄程度中的应用价值。方法经数字减影血管造影确诊的18例移植肾动脉狭窄(TRAS)患者(TRAS组)和18例未见异常的移植肾患者(对照组),应用彩色多普勒超声(CDFI)及超声造影对其进行观察,并比较两组时间-强度曲线(TIC)的差异。结果 CDFI示TRAS组管腔狭窄范围及狭窄程度均小于超声造影所见;对照组TIC曲线呈滑梯状,而TRAS组曲线呈抛物线改变;与对照组比较,TRAS组TIC曲线下降支斜率(ALPHA)、达峰时间(TTP)增高,曲线下面积(AUC)、达峰强度绝对值(DPI)降低,差异均有统计学意义(P0.05),其中以AUC的差异最为显著。结论超声造影能够直观完整地显示移植肾动脉及移植肾内的血流分布,同时进行声学密度定量分析,通过TIC辅助分析移植肾的血流灌注状态,为临床评估TRAS提供新的佐证。

Clinic research on transplanted renal artery stenosis using contrast-enhanced ultrasound and acoustic densitometry quantification

Objective To assess the application value of contrast-enhanced ultrasound and the acoustic densitometry （AD） quantitative analysis technology in observing different narrow degree of transplanted kidney（TK） arterial main force . Methods Diagnosed by digital subtraction angiography , 18 transplanted renal artery stenosis （TRAS） patients （TRAS group） and 18 transplanted renal patient without artery stenosis（control group） were observed using CDFI and contrast-enhanced ultrasound technique,and time-intensity curves （TIC） of different degree of stenosis difference was compared. Results TRAS narrowing range and degree were less detected using CDFI than contrast-enhanced ultrasound,TIC curve was shown as a slide type in normal group,while parabolic type in TRAS group,ALPHA and time to peak increased,while area under curve and derived peak intensity decreased in TRAS group compared with control group（P〈0.05）,in which the difference of area under curve was the most significant. Conclusion Contrast-enhanced ultrasound and AD quantitative analysis technology can display the bloodstream in transplanted kidney and renal arterial intuitively with assistant analysis of TIC,which can provide a new evidence for clinic evaluation of TRAS.