Liu Xinwei, Liu Dikuan, Long Meizhen, Chen Feng
The Affiliated Yiyang Central Hospital, Hunan University of Chinese Medicine, Yiyang, China.
Front Med (Lausanne). 2024 Aug 27;11:1397884. doi: 10.3389/fmed.2024.1397884. eCollection 2024.
Utilize VUEBOX quantitative analysis software to perform quantitative analysis dynamic ultrasound contrast images of post-transplant renal patients were assessed quantitatively five parameters of ultrasonic contrast and two-dimensional ultrasound are examined to explore their six value in Diagnosing Renal Graft Dysfunction.
A retrospective analysis was conducted on 73 post-transplant renal patients who underwent ultrasound contrast examinations at Yiyang Central Hospital from July 2022 to December 2023, They were diagnosed clinically and pathologically. Based on pathological and clinical diagnostic results, the patients were divided into three groups: 47 cases in the stable renal function group, 18 cases in the acute rejection (AR) group, and 8 cases in the delayed graft function (DGF) group. All patients underwent routine ultrasound and ultrasound contrast examinations post-transplantation. By comprehensively assessing renal function test results, clinical course, and pathological findings, differences in ultrasonic contrast quantitative parameters were analyzed. Additionally, ROC curves were constructed to evaluate the diagnostic efficacy of ultrasound contrast in discriminating between transplant renal rejection reactions and delayed renal function recovery.
Statistically significant differences in characteristics, such as renal segmental artery resistance index, were observed among the stable renal function group, AR group, and DGF group (all < 0.05), while peak systolic velocity showed no statistical significance ( > 0.05). Differences in cortical time to peak (TTP), medullary time to peak(TTP), main renal artery rise time (RT), main renal artery(TTP), and main renal artery fall time (FT) were statistically significant among the stable renal function group, AR group, and DGF group ( < 0.05). ROC curve analysis demonstrated that the accuracy of quantitative parameters for the DGF group and AR group was as follows: Renal artery TTP = Renal artery RT > Renal artery FT > Medulla TTP > Cortex TTP (with respective area under the curve values of 0.828, 0.828, 0.758, 0.742, 0.719). Among these, Renal artery TTP and Renal artery RT exhibited larger AUC values, with sensitivities of 87.5% each and specificities of 81.2 and 87.5%, respectively.
There are discernible differences in VUEBOX quantitative parameters between post-transplant AR and DGF cases, thereby providing imaging references for diagnosing of acute rejection and functional impairment following renal transplantation.
利用VUEBOX定量分析软件对移植肾患者的动态超声造影图像进行定量分析，评估超声造影的五个参数及二维超声的两个参数，探讨其在诊断移植肾功能障碍中的价值。
回顾性分析2022年7月至2023年12月在益阳市中心医院接受超声造影检查的73例移植肾患者，对其进行临床及病理诊断。根据病理及临床诊断结果，将患者分为三组：肾功能稳定组47例，急性排斥反应（AR）组18例，移植肾功能延迟恢复（DGF）组8例。所有患者移植后均接受常规超声及超声造影检查。综合评估肾功能检测结果、临床病程及病理表现，分析超声造影定量参数的差异。此外，构建ROC曲线评估超声造影在鉴别移植肾排斥反应与肾功能延迟恢复中的诊断效能。
肾功能稳定组、AR组和DGF组在肾段动脉阻力指数等特征上存在统计学显著差异（均P<0.05），而收缩期峰值流速无统计学意义（P>0.05）。肾功能稳定组、AR组和DGF组在皮质达峰时间（TTP）、髓质达峰时间（TTP）、肾主动脉上升时间（RT）、肾主动脉（TTP）和肾主动脉下降时间（FT）上存在统计学显著差异（P<0.05）。ROC曲线分析显示，DGF组和AR组定量参数的准确性如下：肾动脉TTP = 肾动脉RT > 肾动脉FT > 髓质TTP > 皮质TTP（曲线下面积值分别为0.828、0.828、0.758、0.742、0.719）。其中，肾动脉TTP和肾动脉RT的AUC值较大，敏感性均为87.5%，特异性分别为81.2%和87.5%。
移植后AR和DGF病例的VUEBOX定量参数存在明显差异，为肾移植术后急性排斥反应及功能损害的诊断提供影像学参考。
