首页|超声造影评估2型糖尿病肾病肾脏血流灌注的价值

超声造影评估2型糖尿病肾病肾脏血流灌注的价值

Contrast-Enhanced Ultrasound in Assessing the Blood Perfusion of Kidney in Type 2 Diabetic Nephropathy

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目的 探讨超声造影定量评估肾脏血流灌注辅助诊断2型糖尿病肾病的应用价值.资料与方法 前瞻性纳入2017年5月—2019年12月解放军总医院第一医学中心41例伴肾功能异常拟行肾脏穿刺的2型糖尿病患者,均行肾脏超声造影检查.比较糖尿病肾病和局灶节段性肾小球硬化症造影参数(肾皮质达峰时间、峰值强度、平均渡越时间、肾血流量曲线下面积)的差异,并分析造影参数与病理结果的相关性.结果 41 例患者中,病理诊断为糖尿病肾病 30 例,局灶节段性肾小球硬化症 11 例.糖尿病肾病组峰值强度和曲线下面积明显低于局灶节段性肾小球硬化症[峰值强度:3 837.16(2 449.16,5 929.16)比 8 508.00(4 334.88,21 201.00),Z=-2.766,P=0.006;曲线下面积:0.14±0.05比0.19±0.05,t=-3.135,P=0.003].糖尿病肾病组峰值强度与肾小球全球硬化率呈负相关(r=-0.489,P=0.006).结论 超声造影能够定量评估肾脏的血流灌注,对于辅助诊断2型糖尿病肾病具有一定临床价值.
Purpose To explore the clinical value of quantitative assessment of renal perfusion using ultrasound contrast imaging for the auxiliary diagnosis of type 2 diabetic nephropathy.Materials and Methods This prospective study was conducted from May 2017 to December 2019 at the First Medical Center of Chinese PLA General Hospital.A total of 41 patients with type 2 diabetes and renal function abnormalities,who were scheduled for renal biopsy,underwent contrast-enhanced ultrasound.Differences in contrast imaging parameters,including time to peak in the renal cortex,peak enhancement,mean transit time local,and area under the curve between diabetic nephropathy and focal segmental glomerulosclerosis were compared,and the correlation between imaging parameters and pathological results was analyzed.Results Among 41 patients,30 cases were diagnosed as diabetic nephropathy,and 11 cases were diagnosed as focal segmental glomerulosclerosis.The peak enhancement and area under the curve in the diabetic nephropathy group were significantly lower than those in the focal segmental glomerulosclerosis group[peak enhancement:3 837.16(2 449.16,5 929.16)vs.8 508.00(4 334.88,21 201.00),Z=-2.766,P=0.006;area under the curve:0.14±0.05 vs.0.19±0.05,t=-3.135,P=0.003].In the diabetic nephropathy group,peak enhancement showed a negative correlation with the global glomerulosclerosis rate(r=-0.489,P=0.006).Conclusion Contrast-enhanced ultrasound can quantitatively evaluate renal perfusion and has certain clinical value in assisting the diagnosis of type 2 diabetic nephropathy.

Diabetic nephropathiesDiabetes mellitus,type 2Glomerulosclerosis,focal segmentalGlomerulosclerosisUltrasonographyContrast mediaBlood perfusion

杨维维、王一茹、赵萍、李楠、宋青、罗渝昆、王月香

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解放军总医院第一医学中心超声诊断科,北京 100853

解放军总医院第七医学中心超声诊断科,北京 100010

糖尿病肾病 糖尿病,2型 肾小球硬化症,局灶性节段性 肾小球硬化 超声检查 造影剂 血流灌注

国家自然科学基金面上项目北京市自然科学基金面上项目北京市自然科学基金面上专项军队后勤保障部科研专项

823719857232352M2201521BJZ13

2024

10.3969/j.issn.1005-5185.2024.03.015

中国医学影像学杂志
中国医学影像技术研究会

中国医学影像学杂志

CSTPCD北大核心
影响因子：1.37
ISSN：1005-5185
年,卷(期)：2024.32(3)
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