Non-invasive Evaluation Of Renal Ischemia-reperfusion Injury By ARFI:An Experimental Study

PART IACOUSTIC RADIATION PULSE IMAGING(ARFI)WAS USED TO MONITOR THE CHANGES OF RENAL PARENCHYMA AFTER RENAL PARENCHYMAL ISCHEMIA-REPERFUSION INJURY ObjectiveBy establishing the model of rabbit kidney ischemia-reperfusion injury,the change of the renal parenchymal elastic value after renal ischemia-reperfusion injury was monitored by Acoustic Radiation Pulse Imaging(ARFI).MethodTwenty New Zealand white rabbits were selected and randomly divided into two groups: control group(group C)and renal ischemia-reperfusion injury group(group I/R),10 in each group.After the model of rabbit renal ischemia-reperfusion injury was successfully established,the main section of the long axis of the left kidney was taken,the probe was fixed,and the ARFI function in the ultrasonic diagnosis instrument was opened.The ARFI sampling frame was placed in the middle of the left kidney near the surface of the superficial probe.The rabbits were resuscitated respectively before renal blockade,0h reperfusion,1h reperfusion,6h reperfusion,12 h reperfusion and 24 h reperfusion.The shear wave velocity(SWV)of renal tissue in the sampling frame was measured rapidly and intermittently.The same position needs to be measured 3 ~ 5 times,and the average value is taken.The above examination was performed by two experienced ultrasound physicians.At the same time,renal biopsy was performed at each time point,and the solution was quickly fixed with 10% neutral formalin.Pathological changes were observed under light microscope.ResultsThere was no significant difference in SWV between control group(group C)and before renal block,0h reperfusion and 1h reperfusion group,there was no significant difference(P>0.05).Renal ischemia-reperfusion injury group(group I/R),with the extension of reperfusion time after renovascular blockade,SWV value of renal parenchyma gradually increased at 6h,12 h,24h after reperfusion,the difference was statistically significant(P<0.05).In histopathology,there was no abnormal change of glomerulus,renal tubule and interstitium in rabbits.In group I/R,the structure of glomerulus,renal tubules and interstitium were basically normal at 1 hour after renal ischemiareperfusion,and no significant abnormal changes were observed.With the prolongation of reperfusion time,the pathological changes of the kidneys showed different degrees of renal pathological changes,tubular epithelial cell swelling,balloon-like degeneration,and even coagulation necrosis,glomerular partial atrophy,interstitial congestion,edema,a wide range of Infiltration of neutrophil infiltration.ConclusionIn the process of monitoring renal ischemia-reperfusion injury in rabbits by acoustic radiation force pulsed imaging(ARFI),the change of SWV in renal parenchyma is basically consistent with histopathological changes,and it can be monitored by ARFI in clinical practice.Ischemia-reperfusion injury provides the basis.PART IITHE CORRELATION BETWEEN RENAL PARENCHYMAL ELASTICITY AND RENAL ARTERIAL RESISTANCE INDEX(RI)WAS ANALYZED AFTER RENAL ISCHEMIA-REPERFUSION INJURYObjectiveThe color Doppler was used to monitor the changes of RI in rabbits after renal ischemia-reperfusion injury.The correlation between changes of renal parenchymal elasticity and the changes of renal parenchymal elasticity measured by ARFI was observed.MethodIn the first part,20 New Zealand white rabbits were successfully established in control group(group C)and renal ischemia / reperfusion group(group I/R).Respectively,before renal block,reperfusion 0h,reperfusion 1h,reperfused 6h,reperfused 12 h,reperfused 24 hours at various time points,the rabbit’s respiration interval was measured rapidly.Rabbit renal artery resistance index(RI)was also obtained at each time point by Color Doppler flow imaging(CDFI)ResultsThe data analysis of rabbit main renal artery RI showed that there was no significant difference in RI between the control group(group C)and before renal block、0h reperfusion、1h reperfusion group(P>0.05).Renal ischemia-reperfusion injury group(group I/R),renovascular graft at each time point with the reperfusion time extension,RI of the main renal artery increased gradually,showing an increasing trend,the difference was statistically significant(P<0.05).The changes of SWV in rabbit kidney after ischemia-reperfusion injury were positively correlated with the changes of RI in renal primary renal artery.ConclusionThe changes of SWV in rabbit kidney after ischemia-reperfusion injury were positively correlated with the changes of RI in renal primary renal artery.The rabbit renal parenchymal SWV value measured by ARFI technology is a sensitive index for early diagnosis(24h)of renal ischemia-reperfusion injury,which can be used for post-operative monitoring of renal transplantation.PART IIITHE CORRELATION BETWEEN RENAL PARECHYMAL ELASTICITY AND RENAL FUNCTION WAS ANALYZEDAFTER RENAL ISCHEMIAREPERFUSION INJURYObjectiveARFI technology was used to determine the elasticity value of rabbit renal ischemia-reperfusion injury,and the correlation between the changes of serum creatinine and urea nitrogen was discussed.ResultsIn the first part,20 New Zealand white rabbits were successfully established the control group(group C)and the renal ischemia/reperfusion group(group I/R),respectively,before renal block,reperfusion 0h,reperfusion 1h,reperfusion 6h,reperfusion 12 h,reperfusion 24 h at various time points,the rabbit breath interval measurement of renal parenchymal elastic value rapidly.At the same time,the blood sampling was about 2ml at each time of the experiment.The blood creatinine(Scr)and urea nitrogen(BUN)were measured by 1800 automatic biochemical analyzer(Beckman Coulter,USA)to evaluate the degree of renal injury.ConclusionThere was no significant difference in serum creatinine(Scr)and blood urea nitrogen(BUN)between control group(group C)and before renal block,reperfusion 0h、1h group.Compared with the control group,the level of serum creatinine(Scr)and blood urea nitrogen(BUN)in the group I/R reperfused for 8h、12h、24h increased significantly(P<0.05).The changes of SWV after renal ischemia-reperfusion injury were positively correlated with the changes of serum creatinine and urea nitrogen(P<0.05).ConclusionThere was a positive correlation between the renal parenchymal SWV value and the renal function index.