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张塞1,孙源博2,马小花1,袁博1,刘云双1▲.超微血流成像与彩色多普勒血流成像对慢性肾脏病肾血流灌注分析[J].中国医药科学,2024,14(9):169-173        基金项目:黑龙江省省属高等学校基本科研业务费科研项目(2021-KYYWF-0514)
超微血流成像与彩色多普勒血流成像对慢性肾脏病肾血流灌注分析
Analysis of renal blood flow perfusion in chronic kidney disease using superb micro-vascular imaging and color Doppler flow imaging
  
DOI:
中文关键词:  慢性肾脏病;彩色多普勒;超微血流成像;超声
英文关键词:Chronic kidney disease; Color Doppler; Superb micro-vascular imaging; Ultrasound
作者单位
张塞1,孙源博2,马小花1,袁博1,刘云双1▲ 1.牡丹江医学院附属红旗医院超声科,黑龙江牡丹江 157011; 2.牡丹江医学院附属红旗医院肾内科,黑龙江牡丹江 157011 
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中文摘要:
      [摘要] 目的 应用彩色多普勒血流成像(CDFI)和超微血流成像技术(SMI)评估慢性肾脏病(CKD)不同分期患者肾脏血流灌注情况的临床应用价值。 方法 选取2021年10月至2023年3月在牡丹江医学院附属红旗医院肾内科住院诊断为CKD的患者100例,按照肾病预后质量指南(K/DOQI)将其分为四组(CKD 1~4组)。应用CDFI和SMI技术对肾脏血流灌注情况进行观察,对肾脏血流灌注应用Adler血流分型方法进行半定量评估,应用Mimics软件分析肾皮质感兴趣区血流灌注面积比(AR)进行定量评估,并对二者进行比较分析。 结果 对CKD患者共200个肾脏进行血流灌注分型,SMI显示肾脏血流灌注分型为Ⅰ型的有149个,占比74.5%,Ⅳ~Ⅴ型的有2个,占比1%;CDFI显示肾脏血流灌注分型为Ⅰ型的有83个,占比41.5%,Ⅳ~Ⅴ型的有9个,占比4.5%。对CKD同一分期肾脏血流灌注分型比较,SMI在评价肾脏皮质血流灌注情况优于CDFI(P < 0.05)。应用CDFI、SMI技术对CKD各组间肾皮质感兴趣区AR进行比较,AR(SMI)高于AR(CDFI)(P < 0.05)。对CKD各组间AR(SMI)比较,CKD 1组高于CKD 2~4组(P < 0.05),CKD 2~3组高于CKD 4组(P < 0.05),CKD 2~3组差异无统计学意义(P > 0.05)。 结论 SMI技术对肾脏皮质血流灌注情况优于CDFI技术,可以更准确地评估CKD患者肾脏血流改变,具有较高临床应用价值。
英文摘要:
      [Abstract] Objective To evaluate the clinical application value of color Doppler flow imaging (CDFI) and superb micro-vascular imaging (SMI) in assessing renal blood flow perfusion in patients with chronic kidney disease (CKD) at different phases. Methods A total of 100 patients diagnosed with CKD who were hospitalized in the Department of Nephrology at Hongqi Hospital Affiliated to Mudanjiang Medical University from October 2021 to March 2023 were selected and divided into four groups (CKD 1-4 group) according to the kidney disease outcomes quality initiative (K/DOQI) guidelines. Observation of renal blood flow perfusion was conducted using CDFI and SMI techniques, semi-quantitative assessment of renal blood flow perfusion was conducted using Adler grade of blood flow, quantitative assessment was conducted on the area ratio (AR) of regions of interest of renal cortex using Mimics software, and comparative analysis of the two was conducted. Results 200 kidneys in the CKD patients were graded for blood flow perfusion. SMI showed that 149 kidneys were graded as typeⅠblood flow perfusion, accounting for 74.5%, and 2 kidneys were graded as type Ⅳ-Ⅴ, accounting for 1%. CDFI showed that 83 kidneys were graded as typeⅠrenal blood flow perfusion, accounting for 41.5%, and 9 kidneys were graded as type Ⅳ-Ⅴ, accounting for 4.5%. SMI was superior to CDFI in evaluating blood flow perfusion of the renal cortex in the same stage of CKD (P < 0.05). CDFI and SMI techniques were used to compare the AR of regions of interest of the renal cortex in CKD groups, and AR (SMI) was higher than AR (CDFI) (P < 0.05). When comparing the CKD groups, the AR (SMI) of the CKD 1 group was higher than that of the CKD 2-4 group (P < 0.05), while the CKD 2-3 group was higher than that of the CKD 4 group (P < 0.05). The difference in the CKD 2-3 group was not significant (P > 0.05). Conclusion The SMI technique is superior to the CDFI technique in assessing blood flow perfusion of the renal cortex, and can more accurately assess renal blood flow changes in CKD patients, with high clinical application value.
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