Comparison Study Of Color Doppler Flow Imaging And Contrast-enhanced Ultrasonography In Early Diagnosis Of Chronic Allograft Nephropathy

Objective:In order to find a new index for early diagnosis of chronic allograft nephropathy(CAN)by comparing the characteristics of Color Doppler flow imaging and contrast-enhanced ultrasonography in patients with chronic allgraft nephropathy.Materials and methods:The subjects of the study were 69 patients with renal allograft in The Affiliated hospital of Jinan University from August 2017 to August 2018.According to the clinical symptoms and laboratory examination of renal transplant patients,and refering to the recommendations of the K/DOQI expert Group of the American Foundation for Kidney Disease,on the base of the estimated glomerular filtration rate(eGFR),the patients were divided into four groups: normal group included 21 patients(eGFR ? 90ml/min.1.73),mild reduction group included 25 patients(60 ? eGFR < 90ml/min.1.73),moderate reduction group included 19 patients(30 ? eGFR <60ml/min.1.73),and severe reduction group included 4 patients(15 ? eGFR < 30ml/min.1.73).All patients were examined by color Doppler flow imaging and contrast-enhanced ultrasonography.The peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI)of the renal artery,intersegmental artery,interlobar artery and arcuate artery were measured by color Doppler and spectral Doppler in all patients.The rise time(RT),peak time(TP),Peak halving time(PHT),peak intensity(PI)and area under curve(AUC)in cortex and medulla were analysised by contrast-enhanced echocardiography combined with time-intensity curve quantificationally.To study the perfusion characteristics of color Doppler and contrast-enhanced echocardiography in patients with chronic allgraft nephropathy.Comparing the correlation between all quantitative parameters and renal function index.The difference in enumeration data between all groups were analyzed using the Chi-square test,The one way analysis of variance(ANOVA)followed by Student-Newman-Keuls-Q(SNK)test for data with normal distribution,The Pearsonlinear correlation analysis for the correlation between all quantitative parameters and renal function index.P < 0.05 was considered a statistically significant difference.Results:1.There was no significant difference in the color Doppler parameters between the arterial blood flow parameters between normal group and mild reduction group,But in moderate reduction group,the RI of renal artery and segmental artery were increased,the PSV,EDV of all arteries were decreased and all the RI were increased in severe reduction group.2.Compared with the normal group,the PI-A,AUC-A in cortical were decreased in the mild reduction group,PI-A,AUC-A in cortical and PI-B,AUC-B in medullary were decreased in the moderate reduction group,RT-A,PT-A in cortical and RT-B,PT-B in medullary prolonged and the PI-A,AUC-A in cortical and PI-B,AUC-B in medullary decreased in the severe reduction group.3.The correlation between renal function indexes and PI-A,AUC-A in cortical,AUC-B in medullary were higher than the correlation between RI of renal artery,segmental artery.Conclusion: CEUS combined with TIC quantificationally can find out CAN earlier than CDFI,CEUS can reflect the abnormal blood flow perfusion of the transplanted kidney better than CDFI,which provides a noninvasive new method for early diagnosis of CAN without hepatorenal toxicity.