The Application Value Of Color Doppler Flow Imaging(CDFI) And Three-dimensional Power Doppler Ultrasound (3D-PDUS) In The Research Of Polycystic Kidney Disease

Objective:To characterize the change of renal blood perfusion and total kidney volume in patients with polycystic kidney disease (PKD) by CDFI and3D-PDUS,and to compare the diagnostic value.Methods:165cases divided into PKD group and control group in the study.79patients with ADPKD were chose as the PKD group,62cases with essential hypertension and24cases health adults with normal blood pressure were chose as the control group. Both of the groups were divided into normal BP group, Grade-1hypertensives group, Grade-2hypertensives group and Grade-3hypertensives group by blood pressure. Every cases was detected the renal parameters, such as Peak systolic velocity (PSV), End-diastolic volume (EDV), Resistive index (RI) Pulsed index(PI) and renal2D-volume(by ellipse formula) in each kidney. Vascularizationindex(VI), Flowindex(FI), Vaseularflowindex (VFI) and renal3D-volume were calculated by3D-PDUS. The changes of parameters were compared between the two groups, Correlation analysis of blood pressure grades and renal function were made between the two groups. The best cutoff value of RI、VI2D-volume and3D-volume were analyzed in different renal function ADPKD patients by ROC curve, and compare the diagnostic value.Results:(1) When the blood pressure was occupied normal, the volume of the kidney became bigger and VI was declined (P<0.05) in ADPKD patients; Compared with the control group, in the ADPKD group, PSV and EDV were dramatic declined, RI and PI were gradually increased (P<0.01-0.05), VI dramatic declined and the volume of the kidney markedly augment (P<0.01) in renal aorta and interlobar arterial.(2) VI and BP grade had the negative correlated, but RI、2D-volume,3D-volume and BP grade had the positive correlated instead in ADPKD group. But the index above all had the opposite correlated with eGFR.(3) When kidney function was mild decrease, Ⅵ≤8.85%or3D-volume≥309.5cm3as the cutoff value:Ⅵ≤8.85%, sensitivity=90.5%, specificity=56%, AUC=0.667;3D-volume≥309.5cm3, sensitivity=81%, specificity=44%, AUC=0.765. When kidney function was moderately severe decrease, Ⅵ≤4.32%or3D-volume≥553.2cm3as the cutoff value:Ⅵ≤4.32%, sensitivity=80%, specificity=28%, AUC=0.696;3D-volume≥553.2cm3,sensitivity=86%specificity=43%,AUC=0.796, Both of them were higher than RI and2D-volume in AUC.Conclusion:Compared with CDFI,3D-PDUS can early predict and reflect change of the renal function. The declined of VI and increased of RI、PI、2D-volume、3D-volume indicate the developing of the disease. There had the relationship among renal blood perfusion, blood pressure and renal function.The degree of renal damage could be reliably and objectively assessed by the renal parameters such as RI、VI and renal volume with noninvasive detection.