Kleinert Stefan, Roll Petra, Baumgaertner Christian, Himsel Andrea, Mueller Adelheid, Fleck Martin, Feuchtenberger Martin, Jenett Manfred, Tony Hans-Peter
University Hospital of Wuerzburg, Rheumatology/Clinical Immunology, Oberduerrbacherstr. 6, D-97080 Wuerzburg, Germany.
Open Rheumatol J. 2012;6:50-3. doi: 10.2174/1874312901206010050. Epub 2012 May 30.
Renal damage is common in scleroderma. It can occur acutely or chronically. Renal reserve might already be impaired before it can be detected by laboratory findings. Microbubble-based contrast-enhanced ultrasound has been demonstrated to improve blood perfusion imaging in organs. Therefore, we conducted a study to assess renal perfusion in scleroderma patients utilizing this novel technique.
Microbubble-based contrast agent was infused and destroyed by using high mechanical index by Siemens Sequoia (curved array, 4.5 MHz). Replenishment was recorded for 8 seconds. Regions of interests (ROI) were analyzed in renal parenchyma, interlobular artery and renal pyramid with quantitative contrast software (CUSQ 1.4, Siemens Acuson, Mountain View, California). Time to maximal Enhancement (TmE), maximal enhancement (mE) and maximal enhancement relative to maximal enhancement of the interlobular artery (mE%A) were calculated for different ROIs.
There was a linear correlation between the time to maximal enhancement in the parenchyma and the glomerular filtration rate. However, the other parameters did not reveal significant differences between scleroderma patients and healthy controls.
Renal perfusion of scleroderma patients including the glomerular filtration rate can be assessed using microbubble-based contrast media.
肾脏损害在硬皮病中很常见。它可急性或慢性发生。在实验室检查结果能够检测到之前,肾脏储备功能可能就已经受损。基于微泡的超声造影已被证明可改善器官的血流灌注成像。因此,我们开展了一项研究,利用这项新技术评估硬皮病患者的肾脏灌注情况。
使用西门子Sequoia(弯阵探头,4.5MHz)通过高机械指数注入并破坏基于微泡的造影剂。记录8秒的再充盈情况。使用定量造影软件(CUSQ 1.4,西门子Acuson,加利福尼亚州山景城)对肾实质、小叶间动脉和肾锥体中的感兴趣区域(ROI)进行分析。计算不同ROI的达峰时间(TmE)、最大增强(mE)以及相对于小叶间动脉最大增强的最大增强百分比(mE%A)。
肾实质的达峰时间与肾小球滤过率之间存在线性相关性。然而,硬皮病患者与健康对照之间的其他参数未显示出显著差异。
使用基于微泡的造影剂可以评估硬皮病患者的肾脏灌注情况,包括肾小球滤过率。