实时超声造影评估动脉粥样硬化性肾动脉狭窄术后肾血流灌注

doi:10.7517/issn.1674-0475.211125

摘要/Abstract

摘要： 本文探讨实时超声造影(rTCEUS)评估严重动脉粥样硬化性肾动脉狭窄经皮腔内肾动脉成形术联合支架置入术(PTRAS)后肾血流灌注变化的价值。选择接受PTRAS治疗的严重动脉粥样硬化性肾动脉狭窄(ARAS70％)患者31例作为研究对象,所有患者分别进行彩色编码双功能超声(CCDS)和rTCEUS检查,比较患者PTRAS前后rTCEUS对比增强的时间-强度曲线(TIC)参数。记录治疗前后TIC的形态,计算PTRAS前后参数差异与估算肾小球滤过率(eGFR)差异的相关性。患者PTRAS后峰值强度(PI)、曲线上升斜率(S)较PTRAS前显著升高(P＜0.05),峰值时间(TTP)、平均通过时间(MTT)较PTRAS前显著降低(P＜0.05),患者PTRAS后曲线下面积(AUC)、AUC-流入(AUC-WI)和AUC-清除(AUC-WO)与PTRAS前相比较,差异均无统计学意义(P＞0.05)。ΔeGFR与ΔTTP、ΔMTT、ΔS、ΔAUC、ΔAUC-WI和ΔAUC-WO不存在相关性(P均＞0.05),与ΔPI存在显著正相关(P＜0.05)。通过rTCEUS获得的参数定量评价重度肾动脉狭窄患者PTRAS后肾血流变化具有重要价值。

关键词: 肾动脉狭窄, 经皮腔内肾动脉成形术联合支架置入术, 多普勒超声, 造影, 血流灌注

Abstract: This paper explored the value of real-time contrast-enhanced ultrasonography (rTCEUS) in evaluating renal blood perfusion after percutaneous transluminal renal angioplasty and PTRAS in patients with severe atherosclerotic renal artery stenosis. 31 patients with severe atherosclerotic renal artery stenosis (ARAS 70%) who received PTRAS were selected as the research objects, and all patients underwent color-coded duplex ultrasound (CCDS) and rTCEUS, respectively and compared the time-intensity curve (TIC) parameters of rTCEUS contrast enhancement in patients before and after PTRAS. The morphological changes of TIC before and after PTRAS were recorded, and the correlation between the parameters before and after PTRAS and the estimated glomerular filtration rate (EGFR) was calculated. The peak intensity (PI) and rising slope (S) of the curve after PTRAS were significantly higher than those before PTRAS (P<0.05), while the peak time (TTP) and mean transit time (MTT) were significantly lower than those before PTRAS (P<0.05). There had no significant differences in the area under the curve (AUC), AUC-influx (AUC-WI) and AUC-clearance (AUC-WO) between pre-PTRAS and post-PTRAS (P>0.05). There was no correlation between ΔEGFR and ΔTTP, ΔMTT, ΔS, ΔAUC, ΔAUC-WI and ΔAUC-WO (all P>0.05) except ΔPI with positive correlation (P<0.05). Parameters obtained by rTCEUS have a great value in evaluating the changes of renal blood flow in patients with severe renal artery stenosis after PTRAS.

Key words: renal artery stenosis, percutaneous transluminal angioplasty and stenting, doppler ultrasound, contrast-enhanced, blood perfusion

张艳, 薛英红, 姬冬辉. 实时超声造影评估动脉粥样硬化性肾动脉狭窄术后肾血流灌注[J]. 影像科学与光化学, 2022, 40(3): 464-468.

ZHANG Yan, XUE Yinghong, JI Donghui. The Evaluation of Renal Blood Perfusion after Atherosclerotic Renal Artery Stenosis by rTCEUS[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(3): 464-468.

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