Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China.
Chin Med J (Engl). 2012 Feb;125(4):652-6.
Assessment of perfusion in the early period of acute renal failure (ARF) is important, and can not be made by conventional ultrasound. The aim of this study was to prospectively test in a rabbit ARF model whether real-time contrast-enhanced ultrasound (CEUS) can quantitatively evaluate the hemodynamic changes of renal cortex in the early period.
The model of ARF was induced in 30 healthy New Zealand white rabbits (2.5 - 3.0 kg), by intramuscular injection of 50% glycerin solution (12 ml/kg). CEUS were performed on right kidneys before, 6 and 24 hours after glycerin injection. CEUS quantitative indexes were measured in renal cortex using QLAB software. Comparisons between different stages were performed using paired t test. The sensitivity of CEUS in diagnosing ARF was compared with blood serum urea nitrogen (BUN), serum creatinine (SCr) level and color Doppler flow imaging (CDFI).
Among quantitative indexes, time to peak (TTP) and area under curve (AUC) increased significantly from (5.86 ± 2.57) seconds and (124.4 ± 46.7) dB·s before glycerin injection to (7.66 ± 2.05) seconds and (288.1 ± 64.9) dB·s 6 hours after injection (P < 0.05). Slope rate of ascending curve (A) and descending curve (a) decreased slightly from (3.00 ± 1.22) dB/s and (0.19 ± 0.15) 1/s to (2.80 ± 1.45) dB·s and (0.09 ± 0.02) 1/s (P < 0.05). Twenty-four hours later, only AUC increased significantly from (124.4 ± 46.7) dB·s to (466.2 ± 52.2) dB·s (P < 0.05).
Quantitative indexes of CEUS might be useful in predicting the hemodynamic changes of renal cortex in the early six hours of ARF model.
急性肾衰竭（ARF）早期的灌注评估很重要，但常规超声无法进行。本研究旨在前瞻性地在兔 ARF 模型中检验实时超声造影（CEUS）能否定量评估早期肾皮质的血流动力学变化。
30 只健康新西兰大白兔（2.5-3.0kg）肌肉注射 50%甘油溶液（12ml/kg）建立 ARF 模型。甘油注射前、后 6 小时和 24 小时对右肾进行 CEUS。使用 QLAB 软件测量肾皮质的 CEUS 定量指标。采用配对 t 检验比较不同阶段的差异。比较 CEUS 与血清尿素氮（BUN）、血清肌酐（SCr）水平和彩色多普勒血流成像（CDFI）诊断 ARF 的灵敏度。
定量指标中，达峰时间（TTP）和曲线下面积（AUC）分别从甘油注射前的（5.86±2.57）秒和（124.4±46.7）dB·s增加至注射后 6 小时的（7.66±2.05）秒和（288.1±64.9）dB·s（P<0.05），上升斜率（A）和下降斜率（a）分别从（3.00±1.22）dB/s 和（0.19±0.15）1/s 略降至（2.80±1.45）dB·s 和（0.09±0.02）1/s（P<0.05）。24 小时后，仅 AUC 从（124.4±46.7）dB·s 显著增加至（466.2±52.2）dB·s（P<0.05）。
CEUS 的定量指标可能有助于预测 ARF 模型早期 6 小时内肾皮质的血流动力学变化。
