Huang Xin, Zhang Yao, Zhou Qing, Deng Qing
Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Diagnostics (Basel). 2024 Jun 5;14(11):1192. doi: 10.3390/diagnostics14111192.
The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study-38 with AKI and 24 control patients-from whom renal ultrasounds and clinical data were obtained. SonoVue contrast (1.5 mL) was administered through the elbow vein and contrast-enhanced ultrasound (CEUS) images were obtained on a Mindray Resona A20 ultrasound unit for 2 min. The renal perfusion time-intensity curve (TIC) was analyzed and, after 15 min, additional images were obtained to create a microscopic blood flow map. Microvascular density (MVD) was calculated and its correlation with serum creatinine (Scr) levels was analyzed. There were significant differences in heart rate, Scr, blood urea nitrogen, urine volume at 24 h, and glomerular filtration rate between the two groups ( < 0.01), whereas other characteristics, such as renal morphology, did not differ significantly between the AKI group and control group ( > 0.05). The time to peak and mean transit times of the renal cortex in the AKI group were prolonged compared to those in the control group ( < 0.01), while the peak intensity and area under the TIC were lower than those in the control group ( < 0.05). The MVD of the renal cortex in the AKI group was lower than that in the control group (18.46 ± 5.90% vs. 44.93 ± 11.65%; < 0.01) and the MVD in the AKI group showed a negative correlation with Scr (R = -0.84; < 0.01). Based on the aforementioned results, US SRI can effectively assess renal microcirculation in patients with AKI and is a noninvasive technique for the diagnosis of AKI and quantitative evaluation of renal microcirculation.
本研究旨在探讨超声超分辨率成像（US SRI）在评估急性肾损伤（AKI）患者肾微循环方面的临床适用性。本研究共纳入62例脓毒症患者，其中38例为AKI患者，24例为对照患者，收集了他们的肾脏超声检查结果和临床数据。通过肘静脉注射1.5 mL声诺维造影剂，并在迈瑞Resona A20超声仪上采集2分钟的超声造影（CEUS）图像。分析肾脏灌注时间-强度曲线（TIC），15分钟后，获取额外图像以创建微观血流图。计算微血管密度（MVD），并分析其与血清肌酐（Scr）水平的相关性。两组患者的心率、Scr、血尿素氮、24小时尿量和肾小球滤过率存在显著差异（<0.01），而其他特征，如肾脏形态，在AKI组和对照组之间无显著差异（>0.05）。与对照组相比，AKI组肾皮质的达峰时间和平均通过时间延长（<0.01），而TIC的峰值强度和曲线下面积低于对照组（<0.05）。AKI组肾皮质的MVD低于对照组（18.46±5.90%对44.93±11.65%；<0.01），且AKI组的MVD与Scr呈负相关（R=-0.84；<0.01）。基于上述结果，US SRI可有效评估AKI患者的肾微循环，是一种用于AKI诊断和肾微循环定量评估的非侵入性技术。
