目的: 通过超声造影(contrast－enhanced ultrasonography，CEUS)定量分析犬造模前及造模后肾实质区
血流灌注参数的改变，旨在探讨超声造影定量分析技术在评价犬急性肾功能衰竭中的价值。方法: 本实验研究
选择15 只健康成年雄性犬作为研究对象，经犬后腿多点肌注50%的甘油生理盐水，每千克体重约10mL，建立急
性肾功能衰竭的模型。经犬背头静脉团注超声造影剂Sonovue 0．2mL，两侧肾脏造影间隔时间至少15 min，使用
GE LOGIQ－E 9 超声诊断仪及8 MHz 线阵探头，在低机械指数的模式下，于造模前、造模后6 h 和造模后24 h 分
别对犬两侧肾脏进行常规超声及超声造影检查，实时观察犬肾实质区血流灌注情况。造影结束后，开启时间－强
度曲线(time－intensity curve，TIC)分析软件，选择与声束垂直的肾实质区为感兴趣区域(region of interest，ＲOI)，并
保持ＲOI 的形状、大小、深度和位置不变，根据ＲOI 内造影剂微泡回声信号强度的变化获得TIC 曲线及相应的定
量参数值，包括曲线上升支斜率(ascending curve，A)、曲线下面积(area under curve，AUC)、曲线峰值强度( peak intensity，
PI)、曲线达峰时间(time to peak，TTP)。每次造影前均抽血测量肌酐(serum creatinine，SCr)、尿素氮(blood
serum urea nitrogen，BUN)的值。造模后6 h 造影结束后随机处死一只犬，取出肾脏进行病理学检查;余犬均于实
验结束后全部处死，取出肾脏进行病理学检查。用统计学软件分析比较相同时间段内造影参数值和SCr、BUN
的改变情况。结果: (1)造模前曲线上升支斜率(A)、峰值强度(PI)明显高于造模后;造模前达峰时间(TTP)、曲
线下面积(AUC)明显低于造模后，差异有统计学意义(P＜0．05)。(2)造模后6 h 与造模前生化指标相比较，差异
无统计学意义(P＞0．05)，病理变化不明显。(3)造模后24 h 与造模前生化指标相比较，差异有统计学意义(P＜
0．05)，病理变化明显。结论: 超声造影定量分析技术可以比生化指标更早的反映犬急性肾功能衰竭的血流灌注
改变情况并能做出定量评价，有待于越来越多的应用于临床疾病的诊断。

Objective:To quantitatively assess the parameter alteration of renal cortex blood flow in
dogs of before and after injected glycerin with the contrast－enhanced ultrasound．To evaluate the value
of contrast － enhanced ultrasound quantitative analysis in diagnosing early renal function changes of
dogs．Methods:15 healthy adult dogs were the subjects，The dogs model of AＲF was established by intramuscular
injection of 50%glycerin(10mL /kg)into the hind legs of the dogs．After intravenous bolus
injection of 0．2mL Sonovue in dog’s leg vein．In the pattern of low mechanical index，The conventional
ultrasound and Contrast－enhanced ultrasound examinations were performed for GE LQGIQ－E 9 ultrasonic
diagnostic apparatus and 3．5MHz convex array probe for both kidneys before injection，6 hour
after the injection and 24 hour after the injection．Ｒeal time Contrast－enhanced ultrasound of renal cortex
blood perfusion of dogs were collected successively．Take advantage of the analysis function of timeintensity
curve．Choice the renal cortex which perpendicular to the sound beam to be area－of－interest，
keeping the shape，size，depth and position of the ＲOI unchanged，According to the Sonovue echo sign
strength in the area－of－interest get the time－intensity curve．The slope of ascending curve(A)，area
under curve(AUC)，derived peak intensity(PI)and time to peak(TTP)were measured in renal cortex
of dogs using time－intensity curve software．The blood serum urea nitrogen(BUN)and serum creatinine
( SCr)level were tested before contrast－enhanced ultrasound．Ｒandomly elected one dog to take the kidney
tissue of 6 hours after the injection of glycerin，and to pathologically examine．the rest of dogs were
taken the kidney tissue and examined pathologically after 24 hours contrast－enhanced ultrasound．In the
same time，compared the convert the above parameters and blood test with statistically analyzed
software．Ｒesults(1)A，PI before were significantly high the values after injected glycerin，TTP，AUC
before were significantly low the values after injected glycerin．(2) There was no significant change in
histopathologic analysis 6 hours after the injection of glycerin(P＞0．05)．The pathological change is not
obvious．(3)24 hours later，the histopathologic analysis and typical changes can be observed(P＜0．05)．
Conclusion:Quantitative analysis of contrast－enhanced ultrasound could monitor the changes of blood
perfusion image of the renal cortex of the early renal function changes of dogs than SCr and BUN，has
been more and more used in the diagnosis of clinical disease．

Ｒ445．1

 收稿日期: 2018－06－23;修回日期: 2018－08－15
基金项目: 内蒙古医科大学重大科研项目(NYFYZD2014020)
作者简介: 徐明迪(1990－)，女，赤峰市医院超声科主治医师，医学硕士。
通讯作者: 房秀霞，教授，硕士研究导师，E－mail:fangxiuxia602@ 163．com 内蒙古医科大学附属医院超声科，010050