The New Color Blood Quantitative Technique In The Assessment Of Renal Cortical Perfusion In Hypertensive Patients

Objective:Using Color Doppler Ultrasonography and the blood quantitative technique observe and analyze the changes in all-level sufferers'blood stream perfusion in region of interest (ROI) of renal cortex with the essential hypertension, and discuss the value of this technique detecting the early hypertensive nephropathy.Material and Method:1.Between February 2009 and April 2010,56 diagnostic essential hypertensive patients who are partial out-patient clinic and partial hospitalization from the Heping Hospital of changzhi medical college were enrolled in this study.they are divided to three groups by the pressure value:20 patients of hypertensionⅠlevel(140～159/90～99mmHg),18 patients of hypertensionⅡlevel(160～179/100～109)mmHg,18 patients of hypertensionⅢlevel(≥180/≥110mmHg).In the normal control group,20 healthy people with matched age and gender were enrolled.2.76 patients above—mentioned were all examined by Color Doppler Ultrasonography(Philips 22).All patients with an optimized renal vascular preset and keep all parameters constant during the study.Observing focus of shape, echo and blood stream, registering the size and the Cortical thickness of right kindey. When the image is distinct and the blood signal is stable,breath holding after inhale,save the dynamic color flow imagine about 2～3 cardiac cycle.All the sonographic videos were stored to the hard disk internally installed by the means of DICOM.3.standardized recorded color doppler sonographic videos were installed to the computer with the dedicated pixelflux software,choose the renal cortex area of stabile blood sigal and draw the region of interest(ROI) with the parallelogra.the ROI is divided to equally proximal and distal 50% (p50;d50), choose the objective ROI of videos,it will be evaluated by the pixelflux-software respectively and perfusion measurements were carried out automatically in complete heart cycle.the mean velocity(Vmix);the mean area(Amix) the mean intensity (Imix) and TPI and TRI.4.compared with the blood parameters in proximal and distal 50% (p50;d50)of the cortical area between the case group and the normal control group.Then analyze statistically by the SPSS 16.0.At the same time, compared with the blood parameter in proximal and distal 50% (p50;d50)of the cortical area at the same group.Results:1.the result of general examinationCompared with normal group, the size and the cortical thickness of right kidney and the age in all—level hypertension groups were not marked change.The associativity between the Imix in distal 50%(d50ROI)of the renal cortical and the age was statistically significant ((P<0.05).With the increase of age,the Imix of renal cortical(d50ROI)was descended。2.the blood parameters in proximal 50%(p50ROI)of the cortical area(1)Compared with normal group, the mean velocity(Vmix)and the mean intensity(Imix) in hypertensionⅠlevel group were both smaller, but the TRI was bigger, and the difference between them was not statistically significant ((P>0.05).(2)Compared with normal group,the mean velocity (Vmix)and the mean intensity(Imix) in hypertensionⅡlevel group were both smaller, but the TRI was bigger, and the difference between them was statistically significant((P<0.05).(3)Compared with normal group, the mean velocity(Vmix) and the mean intensity(Imix) in hypertension III level group were both obviously smaller, but the TRI was obviously bigger, and the difference between them was statistically significant ((P<0.01).3.the blood parameters in distal 50% (d50ROI)of the cortical area(1)Compared with normal group, the mean velocity (Vmix) and the mean intensity(Imix) in hypertensionⅠlevel group were both smaller, but the TRI was bigger, and the difference between them was not obviously statistically significant((P>0.05).(2)Compared with normal group, the mean velocity (Vmix) and the mean intensity(Imix) in hypertensionⅡlevel group and hypertensionⅢlevel group were both obviously smaller, but the TRI was obviously bigger, and the difference between them was obviously statistically significant (P<0.01).4.compared with the blood parameters in proximal and distal 50%(p50;d50)of the cortical area at the same group.(1)Compared with proximal 50%(p50ROI)in normal group and all the case groups,the mean intensity(Imix) in the distal 50%(d50ROI) were smaller, but the TRI was bigger,the difference between them was statistically significant (P<0.05).(2) Compared with proximal 50% (p50ROI) in hypertensionⅡlevel group and hypertensionⅢlevel group, the mean velocity (Vmix) in the distal 50%(d50ROI) were both smaller, the difference between them was statistically significant ((P<0.05).But the difference between them in normal group and in hypertensionⅠlevel group was not obviously statistically significant.Conclusion:Color Doppler Ultrasonography and the blood quantitative technique(DTPM)can assess the blood stream perfusion in region of interest (ROI) of renal cortex with the essential hypertension safely,quickly and accurately. The technique has significant function in detecting the early hypertensive nephropathy. Early detecting and interfereing in the change of blood stream in the second-clinical stage is important to guide treatment and clinical prognosis.