Han Byoung Hee, Park Sung Bin
Department of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea.
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Curr Med Imaging. 2021;17(8):1003-1009. doi: 10.2174/1573405617666210127101926.
Contrast-enhanced ultrasound (CEUS) can provide more improved images of renal blood flow and much more information of both macro- and microcirculation of the kidney as compared to Doppler US.
To investigate the usefulness of CEUS by analyzing differences in perfusion-related parameters among the three chronic kidney disease (CKD) subgroups and the control group.
Thirty-eight patients with CKD and 21 controls who were age-matched (20-49 years) were included. Included CKD patients were stratified into three groups according to their eGFR: group I, eGFR ≥ 60 ml/min/1.73 m2 (GFR category I and II); group II, 30 ml/min/1.73 m ≤ eGFR < 60 ml/min/1.73 m (GFR category III); and group III, eGFR < 30 ml/min/1.73 m (GFR category IV and V). Comparisons with the controls (eGFR > 90 ml/min/1.73 m) were performed. Real-time and dynamic renal cortex imaging was performed using CEUS. Time-intensity curves and several bolus model quantitative perfusion parameters were created using the VueBox® quantification software. We compared the parameters among the CKD subgroups and between the CKD and control groups.
Eight patients were included in group I, 12 patients in group II, and 18 patients in group III. Significant differences were noted in the wash-in and wash-out rates between the CKD and control groups (p = 0.027 and p = 0.018, respectively), but not between those of the CKD subgroups. There were no significant differences of other perfusion parameters among the CKD subgroups and between the CKD and control groups.
A few perfusion related CEUS parameters (WiR and WoR) can be used as markers of renal microvascular perfusion relating renal function. CEUS can effectively and quantitatively exhibit the renal microvascular perfusion in patients with CKD as well as normal control participants.
与多普勒超声相比，超声造影（CEUS）能够提供更清晰的肾血流图像以及更多关于肾脏宏观和微观循环的信息。
通过分析三个慢性肾脏病（CKD）亚组与对照组之间灌注相关参数的差异，探讨CEUS的应用价值。
纳入38例CKD患者和21例年龄匹配（20 - 49岁）的对照者。纳入的CKD患者根据估算肾小球滤过率（eGFR）分为三组：第一组，eGFR≥60 ml/min/1.73 m²（GFR 类别 I 和 II）；第二组，30 ml/min/1.73 m≤eGFR＜60 ml/min/1.73 m（GFR 类别 III）；第三组，eGFR＜30 ml/min/1.73 m（GFR 类别 IV 和 V）。与对照组（eGFR＞90 ml/min/1.73 m）进行比较。使用CEUS进行实时动态肾皮质成像。使用VueBox®定量软件创建时间 - 强度曲线和几个团注模型定量灌注参数。我们比较了CKD亚组之间以及CKD组与对照组之间的参数。
第一组纳入8例患者，第二组纳入12例患者，第三组纳入18例患者。CKD组与对照组之间的流入率和流出率存在显著差异（分别为p = 0.027和p = 0.018），但CKD亚组之间无显著差异。CKD亚组之间以及CKD组与对照组之间的其他灌注参数无显著差异。
一些与灌注相关的CEUS参数（WiR和WoR）可作为反映肾功能的肾微血管灌注标志物。CEUS能够有效且定量地显示CKD患者以及正常对照者的肾微血管灌注情况。
