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Abstract：
The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study-38 with AKI and 24 control patients-from whom renal ultrasounds and clinical data were obtained. SonoVue contrast (1.5 mL) was administered through the elbow vein and contrast-enhanced ultrasound (CEUS) images were obtained on a Mindray Resona A20 ultrasound unit for 2 min. The renal perfusion time-intensity curve (TIC) was analyzed and, after 15 min, additional images were obtained to create a microscopic blood flow map. Microvascular density (MVD) was calculated and its correlation with serum creatinine (Scr) levels was analyzed. There were significant differences in heart rate, Scr, blood urea nitrogen, urine volume at 24 h, and glomerular filtration rate between the two groups (p < 0.01), whereas other characteristics, such as renal morphology, did not differ significantly between the AKI group and control group (p > 0.05). The time to peak and mean transit times of the renal cortex in the AKI group were prolonged compared to those in the control group (p < 0.01), while the peak intensity and area under the TIC were lower than those in the control group (p < 0.05). The MVD of the renal cortex in the AKI group was lower than that in the control group (18.46 ± 5.90% vs. 44.93 ± 11.65%; p < 0.01) and the MVD in the AKI group showed a negative correlation with Scr (R = -0.84; p < 0.01). Based on the aforementioned results, US SRI can effectively assess renal microcirculation in patients with AKI and is a noninvasive technique for the diagnosis of AKI and quantitative evaluation of renal microcirculation.
摘要：
本研究旨在探讨超声超分辨率成像(USSRI)评估急性肾损伤(AKI)患者肾微循环的临床应用价值。本研究共纳入62例脓毒症患者-38例AKI患者和24例对照患者-从中获得肾脏超声和临床数据。通过肘静脉施用SonoVue造影剂（1.5mL），并在MindrayResonaA20超声单元上获得2分钟的对比增强超声（CEUS）图像。分析肾灌注时间-强度曲线(TIC),15分钟后,获得额外的图像以创建显微血流图.计算微血管密度（MVD），并分析其与血清肌酐（Scr）水平的相关性。心率有显著差异,Scr,血尿素氮,24小时尿量，两组肾小球滤过率（p<0.01），而其他特征，如肾脏形态学，AKI组与对照组之间无显著差异(p>0.05)。与对照组相比，AKI组的肾皮质达到峰值的时间和平均通过时间延长（p<0.01），而TIC下的峰强度和面积均低于对照组（p<0.05）。AKI组肾皮质MVD低于对照组(18.46±5.90%vs.44.93±11.65％；p<0.01），AKI组的MVD与Scr呈负相关（R=-0.84；p<0.01）。根据上述结果,USSRI可以有效评估AKI患者的肾微循环，是一种诊断AKI和定量评估肾微循环的无创技术。
