CAJ | 학술논문

目的探讨三维血管容积显像在诊断肾移植术后急性排异(AR)中的应用价值.方法对30例肾功能稳定期受检者及13例移植肾AR患者进行彩色多普勒血流显像(CDFI)和三维血管容积参数采集与分析,应用受试者工作特征(ROC)曲线比较各项参数的诊断价值.结果 AR组与移植肾功能稳定组比较,阻力指数(RI)及搏动指数(PI)明显升高,差异有统计学意义(分别为P<0.005、P<O.05).7项分析参数中血管血流指数(VFI)ROC曲线下面积最大;VFI与血管指数(VI)、血流指数(FI)、灰阶指数(MG)ROC曲线下面积比较差异无统计学意义(P>0.05);VFI与RI、体积(V)、PI曲线下面积比较差异有统计学意义(P<0.05).以VFI≤18.78%作为临界值,诊断AR的敏感性为70.O%,特异性为93.3%,阳性预测值为60.8%,阴性预测值为93.4%.结论三维血管容积显像参数VFI诊断AR的特异性和敏感性高于血流参数RI和PI;VFI的最佳临界点为≤18.78%.可能为早期诊断AR提供新的有用指标.
목적 탐토삼유혈관용적현상재진단신이식술후급성배이(AR)중적응용개치.방법 대30례신공능은정기수검자급13례이식신AR환자진행채색다보륵혈류현상(CDFI)화삼유혈관용적삼수채집여분석,응용수시자공작특정(ROC)곡선비교각항삼수적진단개치.결과 AR조여이식신공능은정조비교,조력지수(RI)급박동지수(PI)명현승고,차이유통계학의의(분별위P<0.005、P<O.05).7항분석삼수중혈관혈류지수(VFI)ROC곡선하면적최대;VFI여혈관지수(VI)、혈류지수(FI)、회계지수(MG)ROC곡선하면적비교차이무통계학의의(P>0.05);VFI여RI、체적(V)、PI곡선하면적비교차이유통계학의의(P<0.05).이VFI≤18.78%작위림계치,진단AR적민감성위70.O%,특이성위93.3%,양성예측치위60.8%,음성예측치위93.4%.결론 삼유혈관용적현상삼수VFI진단AR적특이성화민감성고우혈류삼수RI화PI;VFI적최가림계점위≤18.78%.가능위조기진단AR제공신적유용지표.
Objective To evaluate the value of three-dimensional (3D) ultrasonic imaging of vascular volume in assessing postoperative acute rejection(AR) of renal transplant patients. Methods Color Doppler flow imaging(CDFI) and 3D vascular volumetric parameters were collected and analyzed in 30 cases with stable renal function (control group) and 13 cases with AR of kidney transplantation (AR group). The diagnostic performances of each ultrasonic parameter were compared by receiver operating characteristic (ROC) curve. Results The parameters of resistance index(RI) and pulsatility index(PI) in AR group were significantly higher than those in control group( P <0.005 and P <0. 05, respectively). Analysis of the areas under ROC curve showed that the area under VFI curve was the largest;no significant difference( P > 0. 05) was found compared the area under VFI curve to those areas under VI,FI and MG curves;Comparing the area under VFI curve to those under RI, V and PI,there were significant differences( P <0. 05). Taking VFI≤18. 78% as the critical value, the sensitivity and specificity for the diagnosis of AR of transplanted kidneys were 70. 0% and 93. 3% ,and the positive and negative predictive values were 60. 8% and 93. 4%, respectively. Conclusions The sensitivity and specifity of 3D vascular volumetric imaging parameter VFI in the diagnosis of transplanted kidneys with AR were higher than those of blood flow parameters RI and PL VFI with the optimal critical value of ≤18. 78% might be a useful index for the early diagnosis of transplanted kidneys with AR.