Application of Contrast-Enhanced Ultrasound in the Evaluation of Prognosis of Acute Kidney Injury in Critically Ill Patients

Abstract

Evaluation of renal function in critically ill patients by contrast-enhanced ultrasonography, and to determine the relationship between contrast-enhanced ultrasound and renal function in patients with acute kidney injury. 60 patients with acute renal injury (AKI) in Tianjin Third Central Hospital from January, 2015 to December ,2016 were selected as A group, at the same time, 30 healthy volunteers were selected as B group. Laboratory examinations such as renal function, cystatin C and other indicators were measured and the creatinine clearance rate was calculated in 24h. Real time contrast-enhanced ultrasound was performed on all the patients with Philips iU22 ultrasound diagnostic apparatus. The ultrasound contrast agent was SonoVue. The software(Q-lab) calculates the intensity of the echo signal of the contrast agent in the region of interest and generates the time intensity curve(TIC). Quantitative parameters of contrast-enhanced ultrasound were obtained: Peak intensity (PI), time to peak time (TTP), area under the curve (AUC), time of arrival (AT), slope of the rising curve(A). According to the results of A group and B group compared with contrast-enhanced ultrasound, were divided into negative and positive. All patients in the A group received comprehensive therapy including continuous hemofiltration. According to whether the patients need renal replacement therapy, renal function and urine volume recovery, the A group patients were divided into the treatment group, the improvement group and the ineffective group. Pearson chi square test was used to analyze the relationship between the results of CEUS and the prognosis of the treatment group. 1.Of the 60 selected cases, there were 26 cases in the treatment group(43.3%), the improvement group of 19 cases(31.7%), the invalid group of 15 cases, (25%). There was no significant difference in creatinine clearance rate and cystatin between the cured group, the improvement group and the ineffective group (P<0.05). 2. In the cured group, CEUS was positive in 7 cases and negative in 19 cases. In the improved group, CEUS was positive in 8 cases and negative in 11 cases, and in the negative group, CEUS was positive in 13 cases and negative in the 2 cases.3. The results of CEUS were significantly correlated with renal prognosis (X2=13.516 P=0.001). The results of this study show that there is a significant correlation between CEUS and renal prognosis of patients with AKI. This application can be used as a new method to evaluate the prognosis of renal function in patients with AKI, and to guide the early intervention treatment of AKI patients.