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彩色多普勒超声评估放射性造影剂对肾动脉阻力指数的影响。

Assessment of the effect of radio contrast media on resistive index of renal artery by color doppler sonography.

作者信息

Shakourirad Ali, Ataeefar Mehdi, Jozaghi Solmaz

机构信息

Department of Radiology, Sina Hospital, Medical Sciences/University of Tehran, Tehran, Iran.

出版信息

Saudi J Kidney Dis Transpl. 2009 Jan;20(1):91-6.

Abstract

Renal ischemia and direct toxic effect of contrast media are the main confounding causes of contrast-induced nephropathy (CIN). The effect of different contrast mediums on the resistance of renal artery is quite unclear. The aim of the present study was to assess the resistive index (RI) changes of renal segmental artery in color Doppler duplex sonography after injection of two different contrast mediums: iodixanol and iohexol. The RI of the renal segmental artery of 62 randomly chosen patients, with a normal baseline renal function, was calculated using color-coded Doppler sonography before and five minutes after bolus injection of two different contrast mediums. Thirty-one patients were administered 50 mL of iodixanol (Visipaque) and 31 patients were administered 50 mL of iohexol (Omnipaque) during intravenous urogram procedures. The RI results were analyzed and compared in two groups using two-tailed t-test. The mean RI of renal segmental artery increased significantly after administration of contrast media (mean +/- SD 0.61 +/- 0.046 vs 0.58 +/- 0.042; p< 0.001). The mean change of RI was 0.0387 +/- .00552 (mean +/- SE) in the setting of iohexol injection and 0.0216 +/- .00423 (mean +/- SE) five minutes after administration of iodixanol (p= 0.017). Both non-ionic iso-osmolar dimeric iodixanol and low-osmolar iohexol increase the renal artery resistance, but the changes are more dramatic with iohexol, suggesting better tolerance with iodixanol.

摘要

肾缺血和造影剂的直接毒性作用是造影剂肾病(CIN)的主要混杂病因。不同造影剂对肾动脉阻力的影响尚不清楚。本研究的目的是评估注射两种不同造影剂(碘克沙醇和碘海醇)后彩色多普勒超声检查中肾段动脉阻力指数(RI)的变化。在62例随机选择的基线肾功能正常的患者中,在静脉推注两种不同造影剂之前和之后5分钟,使用彩色编码多普勒超声计算肾段动脉的RI。在静脉尿路造影过程中,31例患者给予50 mL碘克沙醇(威视派克),31例患者给予50 mL碘海醇(欧乃派克)。使用双尾t检验对两组的RI结果进行分析和比较。注射造影剂后肾段动脉的平均RI显著增加(平均±标准差0.61±0.046对0.58±0.042;p<0.001)。注射碘海醇时RI的平均变化为0.0387±.00552(平均±标准误),注射碘克沙醇后5分钟为0.0216±.00423(平均±标准误)(p=0.017)。非离子等渗二聚体碘克沙醇和低渗碘海醇均增加肾动脉阻力,但碘海醇引起的变化更显著,提示碘克沙醇的耐受性更好。

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