Possibilities of using contrast-enhanced ultrasound in formation of virtual dynamic nephroscintigraphy protocol in patients with type II diabetes mellitus

Abstract

Objective. To evaluate the effectiveness of contrast-enhanced ultrasound in the formation of the protocol of virtual dynamic nephroscintigraphy in patients with type 2 diabetes mellitus. Materials and methods. All patients were examined according to a single diagnostic algorithm, which included four stages: 1) multiparametric ultrasound examination of the kidneys in the In-mode; 2) Doppler assessment of the state of intrarenal blood flow in this group of patients; 3) carrying out CEUS of the kidneys in accordance with European recommendations for clinical practice on contrast-enhanced ultrasound examination followed by the calculation of virtual dynamic nephroscintigraphy; 4) carrying out dynamic nephroscintigraphy according to standard the methodology as a reference method. Results. In the course of the study, patients (n = 32) with a clinical diagnosis of type 2 diabetes mellitus of varying severity were examined. All patients were divided into 2 groups of 16 people each, depending on the results of glomerular filtration rate (GFR). The time of maximum accumulation of contrast agent in group 1 (patients with type 2 diabetes and GFR greater than 60 ml/min/1.73 m2) is quantitatively less than in group 2 (patients with type 2 diabetes and GFR 30–44 ml/min/1.73 m2). The half-life of the contrast agent in groups 1 and 2 does not change significantly. When performing virtual dynamic nephroscintigraphy in patients of the 1st and 2nd groups, the results correlating with the reference method – dynamic nephroscintigraphy were obtained. Conclusion. The method of using contrast-enhanced ultrasound in the formation of the protocol of virtual dynamic nephroscintigraphy in patients with type 2 diabetes mellitus allows us to obtain quantitative indicators of dynamic nephroscintigraphy for subsequent medical conclusions, as well as the possibility of dynamic monitoring of the course of the disease without the use of ionizing research methods.