超声造影技术对糖尿病肾病患者早期肾功能改变的评估及其临床意义

目的：通过超声造影（CEUS）定量分析糖尿病肾病（DN）患者肾血流灌注参数改变，探讨该技术在诊断DN患者早期肾功能改变中的价值。方法：40例糖尿病患者根据Mogensen分期标准分为正常白蛋白尿组（Ⅰ组）及早期DN组（Ⅱ组），15例健康志愿者为对照组（N组）。所有检查者均行肾CEUS灌注成像，并用QontraXt图像分析软件在肾皮质选取感兴趣区域（ROI），生成时间-强度曲线（TIC），获得肾血流灌注参数。结果：CEUS能清晰显示造
影剂在肾脏的灌注过程，与N组比较,Ⅰ组患者肾脏局部血容量（RBV）增多、达峰时间（TTP）和平均渡越时间（MTT）延长，差异有统计学意义( P<0.05 )，而达峰强度（DPI）及局部血流量（RBF）组间比较差异无统计学意义(P＞0.05 )；与N组及Ⅰ组比较，Ⅱ组患者RBV、TTP和MTT 明显增高，DPI、RBF明显降低，差异均有统计学意义( P< 0.05 )。结论：CEUS技术分析早期DN患者血流灌注参数的改变，可以评估DN患者早期肾功能异常。

Evaluation on changes of early renal function in patients with diabetic nephropathy with contrast-enhanced ultrasound and its clinical significance

Objective To quantitively assess the parameter alteration of renal blood flow in patients with diabetic nephropathy(DN) with the contrast-enhanced ultrasound(CEUS),and to evaluate the value of the technique in diagnosis of early renal function changes of DN patients.Methods 40 diabetic patients were equally divided into two groups according to Mogensen' s staging criteria: normal albuminuria group(group Ⅰ) and early DN group(group Ⅱ);and 15 cases of healthy volunteers were used as control group(N group)(n=15).All subjects were performed renal CEUS perfusion imaging,and QontraXt image analysis software was applied to select the region of interest(ROI) in the renal cortex.Then the time intensity curve(TIC) and kidney blood perfusion parameters were collected.Results The renal blood perfusion was clearly shown in real time CEUS;compared with N group,the time to peak(TTP),regional blood volume(RBV),and mean transit time(MTT) of the patients in group Ⅰ were increased,there were significant differences(P<0.05);but there were no significant differences of derived peak intensity(DPI) and regional blood flow(RBF) between two groups(P> 0.05).Compared with group Ⅰ and N group,the RBV,TTP and MTT of the patients were increased,the DPI and RBF were reduced in group Ⅱ,there were significant differences(P<0.05).Conclusion The CEUS technical analysis can be used in evaluating renal abnormality of the DN patients in early period by showing the changes of renal perfusion parameters.