Kalantarinia Kambiz, Belcik J Todd, Patrie James T, Wei Kevin
Div. of Nephrology, Univ. of Virginia Health System, Box 800133, Charlottesville, VA 22908, USA.
Am J Physiol Renal Physiol. 2009 Oct;297(4):F1129-34. doi: 10.1152/ajprenal.00172.2009. Epub 2009 Jul 22.
Current methods for measuring renal blood flow (RBF) are time consuming and not widely available. Contrast-enhanced ultrasound (CEU) is a safe and noninvasive imaging technique suitable for assessment of tissue blood flow, which has been used clinically to assess myocardial blood flow. We tested the utility of CEU in monitoring changes in RBF in healthy volunteers. We utilized CEU to monitor the expected increase in RBF following a high protein meal in healthy adults. Renal cortical perfusion was assessed by CEU using low mechanical index (MI) power modulation Angio during continuous infusions of Definity. Following destruction of tissue microbubbles using ultrasound at a MI of 1.0, the rate of tissue replenishment with microbubbles and the plateau acoustic intensity (AI) were used to estimate the RBF velocity and cortical blood volume, respectively. Healthy adults (n = 19, mean age 26.6 yr) were enrolled. The A.beta parameter of CEU, representing mean RBF increased by 42.8%from a baseline of 17.05 +/- 6.23 to 23.60 +/- 6.76 dB/s 2 h after the ingestion of the high-protein meal (P = 0.002). Similarly, there was a 37.3%increase in the beta parameter, representing the geometric mean of blood velocity after the high protein meal (P < 0.001). The change in cortical blood volume was not significant (P = 0.89). Infusion time of Definity was 6.3 +/- 2.0 min. The ultrasound contrast agent was tolerated well with no serious adverse events. CEU is a fast, noninvasive, and practical imaging technique that may be useful for monitoring renal blood velocity, volume, and flow.
目前测量肾血流量(RBF)的方法耗时且未广泛应用。超声造影(CEU)是一种安全无创的成像技术,适用于评估组织血流,已在临床上用于评估心肌血流。我们测试了CEU在监测健康志愿者肾血流量变化方面的效用。我们利用CEU监测健康成年人高蛋白餐后肾血流量的预期增加。在持续输注Definity期间,使用低机械指数(MI)功率调制血管造影通过CEU评估肾皮质灌注。在MI为1.0时用超声破坏组织微泡后,分别用微泡组织再填充率和平稳声强(AI)来估计肾血流量速度和皮质血容量。纳入了健康成年人(n = 19,平均年龄26.6岁)。代表平均肾血流量的CEU的A.beta参数在摄入高蛋白餐后2小时从基线的17.05±6.23 dB/s增加了42.8%,达到23.60±6.76 dB/s(P = 0.002)。同样,代表高蛋白餐后血流速度几何平均值的beta参数增加了37.3%(P < 0.001)。皮质血容量的变化不显著(P = 0.89)。Definity的输注时间为6.3±2.0分钟。超声造影剂耐受性良好,未发生严重不良事件。CEU是一种快速、无创且实用的成像技术,可能有助于监测肾血流速度、容量和流量。