Yücel C, Ozdemir H, Akpek S, Gürel K, Kapucu L O, Araç M
Department of Radiology, Gazi University School of Medicine, Beşevler, 06510 Ankara, Turkey.
J Clin Ultrasound. 2001 May;29(4):237-42. doi: 10.1002/jcu.1026.
Power Doppler sonography (PDUS) is a promising technique for the diagnosis of renal infarcts. PDUS's efficacy may be enhanced by using sonographic contrast agents. We evaluated 3 cases of renal infarction using PDUS and the sonographic contrast agent Levovist. The findings were compared with those of other imaging modalities, such as scintigraphy, CT, and angiography. In case 1, PDUS showed a patent interlobar artery only in the lower part of the right kidney and no other perfusion of the right renal parenchyma. Contrast-enhanced PDUS showed patchy areas of preserved perfusion in the lower and middle-upper anterior portions of the kidney. In case 2, PDUS showed diffuse and patchy perfusion defects in the anterolateral portion of the right kidney. On contrast-enhanced PDUS, no signal enhancement was seen in these areas, but the perfusion defects were better delineated. In case 3, PDUS showed no perfusion in the upper pole of the kidney; the nonperfused area extended to the posterior upper portion of the kidney but could not be distinguished from normal tissue. After injection of the contrast agent, there was no enhancement of the posterior extension of the upper pole infarct, but Doppler signals from the surrounding normal parenchyma were enhanced, so the area was more clearly demarcated. The administration of the contrast agent facilitated the visualization of the infarcts in all 3 cases.
能量多普勒超声检查（PDUS）是诊断肾梗死的一种很有前景的技术。使用超声造影剂可能会提高PDUS的效能。我们使用PDUS和超声造影剂声诺维评估了3例肾梗死病例。将结果与其他成像方式（如闪烁扫描、CT和血管造影）的结果进行了比较。病例1中，PDUS显示仅右肾下部的叶间动脉通畅，右肾实质无其他灌注。超声造影增强的PDUS显示肾下部和中上前部有散在的灌注保留区域。病例2中，PDUS显示右肾前外侧部分有弥漫性和散在的灌注缺损。在超声造影增强的PDUS上，这些区域未见信号增强，但灌注缺损更清晰。病例3中，PDUS显示肾上部无灌注；无灌注区域延伸至肾后部上部，但无法与正常组织区分。注射造影剂后，肾上极梗死的后部延伸区域无增强，但周围正常实质的多普勒信号增强，因此该区域更清晰地被划定。在所有3例病例中，造影剂的使用都有助于梗死灶的显示。
