Yi Chunbei, Zhang Fang, Shi Jing, Zhang Jian, Du Jun
Department of Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Pediatr. 2025 Jun 13;13:1574398. doi: 10.3389/fped.2025.1574398. eCollection 2025.
To explore the correlation between the quantitative analysis curve of renal contrast-enhanced ultrasound and the anatomical location of renal cortical microcirculation associated with acute kidney injury.
This study included a 1-year-and-11-month-old female child with acute kidney injury caused by drug overdosed and a 14-year-old female child with acute kidney injury caused by drug intentional, who were treated at Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine. Both patients underwent renal contrast-enhanced ultrasound and quantitative analysis. In addition, their clinical medical history data were recorded.
The first child developed acute kidney injury owing to cyclosporine A overdosed. Contrast-enhanced ultrasound revealed poor cortical blood flow perfusion in both kidneys, with abnormally prolonged cortical perfusion times and possible obstruction of vascular inflow pathways. The second child experienced acute kidney injury owing to ibuprofen intentional. Contrast-enhanced ultrasound showed good cortical blood wash-in/perfusion but significantly delayed wash-out/excretion.
The structure and function of the glomerulus significantly influence the perfusion rate and intensity of the rising branch of the curve. Furthermore, the descending branch of the curve is affected by the interplay of the capillaries surrounding the renal tubules. Exploration of these anatomical structures aids in understanding the renal microcirculation pathways and provides further insight into renal perfusion dynamics.
探讨肾超声造影定量分析曲线与急性肾损伤相关的肾皮质微循环解剖位置之间的相关性。
本研究纳入了一名因药物过量导致急性肾损伤的1岁11个月女童和一名因故意服药导致急性肾损伤的14岁女童，她们均在上海交通大学医学院附属上海儿童医学中心接受治疗。两名患者均接受了肾超声造影及定量分析。此外，记录了她们的临床病史资料。
第一个孩子因环孢素A过量导致急性肾损伤。超声造影显示双肾皮质血流灌注不佳，皮质灌注时间异常延长，血管流入途径可能受阻。第二个孩子因故意服用布洛芬导致急性肾损伤。超声造影显示皮质血流灌注良好，但洗脱/排泄明显延迟。
肾小球的结构和功能显著影响曲线上升支的灌注速率和强度。此外，曲线下降支受肾小管周围毛细血管相互作用的影响。对这些解剖结构的探索有助于理解肾微循环途径，并进一步深入了解肾灌注动力学。
