Nestola Manuela, De Matthaeis Nicoletta, Ferraro Pietro Manuel, Fuso Paola, Costanzi Stefano, Zannoni Gian Franco, Pizzolante Fabrizio, Vasquez Quadra Sabina, Gambaro Giovanni, Rapaccini Gian Ludovico
Altamedica Artemisia, Viale Liegi 45, 00198, Rome, Italy.
Gastroenterology Unit, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
J Ultrasound. 2018 Jun;21(2):81-87. doi: 10.1007/s40477-018-0298-1. Epub 2018 Apr 24.
To compare contrast-enhanced ultrasonography (CEUS)-derived time-intensity (TI) curves with histological findings in kidneys of patients affected by chronic glomerulonephritides (GN) in the early stage of disease.
Research ethics committee approval and patient written informed consent were obtained. Thirty-one patients who showed clinical and laboratory signs of GN, with preserved renal function, were consecutively enrolled. They underwent kidney CEUS, from which TI curves were obtained, and kidney biopsy. TI curves were compared with clinical data, ultrasound (US) Doppler, and histological parameters.
The persistence of contrast agent signal during the wash-out phase was found to be correlated with the degree of disease activity (p = 0.016) and in particular with the presence of mesangial hyperplasia (p = 0.008). No correlation was observed between TI curves and clinical or Doppler US-derived parameters.
The persistence of contrast agent signal in the wash-out phase of CEUS appears to reflect a disturbance of perfusion in glomerular capillaries in the early stages of GN. We found that the histological element directly correlated with the prolonged wash-out was mesangial hyperplasia.
比较慢性肾小球肾炎（GN）疾病早期患者肾脏的超声造影（CEUS）时间-强度（TI）曲线与组织学结果。
获得研究伦理委员会批准和患者书面知情同意。连续纳入31例表现出GN临床和实验室体征且肾功能保留的患者。他们接受了肾脏CEUS检查，从中获取TI曲线，并进行肾脏活检。将TI曲线与临床数据、超声（US）多普勒及组织学参数进行比较。
发现造影剂信号在消退期的持续存在与疾病活动程度相关（p = 0.016），特别是与系膜增生的存在相关（p = 0.008）。未观察到TI曲线与临床或多普勒超声衍生参数之间的相关性。
CEUS消退期造影剂信号的持续存在似乎反映了GN早期肾小球毛细血管灌注的紊乱。我们发现与消退期延长直接相关的组织学成分是系膜增生。
