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放射性碘治疗前后甲亢猫肾灌注的评估

Evaluation of Renal Perfusion in Hyperthyroid Cats before and after Radioiodine Treatment.

作者信息

Stock E, Daminet S, Paepe D, Buresova E, Vandermeulen E, Smets P, Duchateau L, Saunders J H, Vanderperren K

机构信息

Department of Medical Imaging of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

出版信息

J Vet Intern Med. 2017 Nov;31(6):1658-1663. doi: 10.1111/jvim.14852. Epub 2017 Oct 14.

Abstract

BACKGROUND

Hyperthyroidism and chronic kidney disease (CKD) are common in elderly cats. Consequently, both diseases often occur concurrently. Furthermore, renal function is affected by thyroid status. Because changes in renal perfusion play an important role in functional renal changes in hyperthyroid cats, investigation of renal perfusion may provide novel insights.

OBJECTIVES

To evaluate renal perfusion in hyperthyroid cats with contrast-enhanced ultrasound (CEUS).

ANIMALS

A total of 42 hyperthyroid cats was included and evaluated before and 1 month after radioiodine treatment.

METHODS

Prospective intrasubject clinical trial of contrast-enhanced ultrasound using a commercial contrast agent (SonoVue) to evaluate renal perfusion. Time-intensity curves were created, and perfusion parameters were calculated by off-line software. A linear mixed model was used to examine differences between pre- and post-treatment perfusion parameters.

RESULTS

An increase in several time-related perfusion parameters was observed after radioiodine treatment, indicating a decreased blood velocity upon resolution of the hyperthyroid state. Furthermore, a small post-treatment decrease in peak enhancement was present in the renal medulla, suggesting a lower medullary blood volume.

CONCLUSIONS AND CLINICAL IMPORTANCE

Contrast-enhanced ultrasound indicated a higher cortical and medullary blood velocity and higher medullary blood volume in hyperthyroid cats before radioactive treatment in comparison with 1-month post-treatment control.

摘要

背景

甲状腺功能亢进和慢性肾病(CKD)在老年猫中很常见。因此,这两种疾病常常同时发生。此外,肾功能受甲状腺状态影响。由于肾灌注变化在甲状腺功能亢进猫的肾功能变化中起重要作用,对肾灌注的研究可能会提供新的见解。

目的

使用超声造影(CEUS)评估甲状腺功能亢进猫的肾灌注。

动物

共纳入42只甲状腺功能亢进猫,并在放射性碘治疗前和治疗后1个月进行评估。

方法

采用商业造影剂(声诺维)进行超声造影的前瞻性个体内临床试验,以评估肾灌注。绘制时间-强度曲线,并通过离线软件计算灌注参数。使用线性混合模型检查治疗前和治疗后灌注参数之间的差异。

结果

放射性碘治疗后观察到几个与时间相关的灌注参数增加,表明甲状腺功能亢进状态缓解后血流速度降低。此外,治疗后肾髓质的峰值增强略有下降,提示髓质血容量较低。

结论及临床意义

与治疗后1个月的对照相比,超声造影显示放射性治疗前甲状腺功能亢进猫的皮质和髓质血流速度较高,髓质血容量较大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a499/5697172/de47be48c5b4/JVIM-31-1658-g001.jpg

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