Color Doppler And Superb Micro-vascular Imaging For Chronic Kidney Disease Renal Blood Perfusion

Objective:To investigate the clinical value of color doppler flow imaging(CDFI)and superb micro-vascular imaging(SMI)on renal blood perfusion changes in patients with chronic kidney disease(CKD)and to analyze the correlation between SMI renal blood perfusion image grade and clinical stage in patients with CKD.Methods:From January 2019 to March 2020,62 patients(124 kidneys)with CKD diagnosed in our hospital and 34 normal subjects(68kidneys)undergoing physical examination in the same period were selected as the study subjects.They were divided into case group and control group.According to the K/DOQI staging criteria of chronic kidney disease,62 patients with CKD were divided into four groups:namely CKD stage 1,CKD stage 2,CKD stage 3,and CKD stage 4-5.Two-dimensional ultrasonography was used to measure the size and parenchymal thickness of bilateral kidneys in the control group and the case group,and CDFI mode and SMI mode were used to observe the blood perfusion of bilateral kidneys in all subjects,and the blood perfusion was graded and recorded.Meanwhile,Spearman analysis was used to analyze the correlation between CDFI,SMI blood perfusion grade and the first three clinical stages of CKD.Results:1.Two-dimensional ultrasound examination:There were significant differences in kidney length diameter,width diameter,thickness diameter and parenchymal thickness between case group and normal group(P<0.05).2.The results of CDFI detection of renal blood perfusion:There was no significant difference in the renal blood perfusion grading between the control group and CKD1 and CKD2 stages(P>0.01),and a statistically significant difference(P<0.01)in the renal blood perfusion grading between the control group and CKD3 and CKD4-5 stages.Pair comparison of CKD1,CKD2 and CKD3 stages in renal blood perfusion grading showed no statistically significant difference(P>0.01),the difference was statistically significant compared with CKD stage 4-5(P<0.01).In control group,CKD1 and CKD2 stage,the blood perfusion was mainly at the level of arcuate artery,CKD3 stage was mainly at the level of interlobar artery,and CKD4-5 stage was mainly at the level of intersegment artery.The higher the CKD stage,the lower the CDFI renal perfusion grade.3.The results of SMI detection of renal blood perfusion:Pair comparison of control group,CKD1 stage and CKD2 stage in renal blood perfusion grading showed no statistical significance(P>0.01).The differences in renal blood perfusion grading were statistically significant(P<0.01)in the control group,CKD1 stage and CKD2 stage compared with CKD3 stage and CKD4-5 stage,respectively.The difference in renal blood perfusion grading between CKD stage 3 and CKD stage 4-5 was statistically significant(P<0.01).The blood perfusion in control group,CKD1 stageand CKD2 stagewas mainly at the level of interlobular artery;the blood perfusion in CKD3 stagewas mainly at the level of arched artery;and the blood perfusion in CKD4-5 stagewas mainly at the level of interlobular artery.The higher the CKD stage,the lower the renalperfusion grade of SMI.4.Comparison of CDFI and SMI evaluation of renal blood perfusion:The difference between CDFI and SMI was statistically significant(P<0.05)for the comparison of renal blood perfusion grading in the same period of CKD.The distribution of renal blood flow in the subjects was 71.3%for SMI showing grade 4-5 and54.7%for CDFI showing grade4-5.5.The correlation analysis between renal blood perfusion grade and clinical stage of CKD by SMI and CDFI:There was a strong correlation between renal blood perfusion grade and clinical stage of CKD in SMI(Rs=-0.657,P<0.01)and was a moderate correlation between renal blood perfusion grade and clinical stage of CKD in CDFI(Rs=-0.419,P<0.01).Conclusion:CDFI and SMI can effectively detect the decrease of renal perfusion in CKD patients,and CDFI can effectively detect the decrease of renal perfusion in CKD stage 4-5,while SMI can effectively detect the decrease of renal perfusion in CKD stage 3,and SMI can detect the change of renal perfusion earlier than CDFI;SMI can show the renal vessels at different clinical stages of CKD better than CDFI.The ability of SMI to display renal blood vessels at different clinical stages of CKD is better than that of CDFI,and there is a strong correlation between SMI renal perfusion image grading and clinical stage of CKD,which can provide an important imaging basis for clinical diagnosis and treatment.