Renal Function Evaluation with Color Doppler Ultrasound Before and After Ultrasonic Pneumatic Ballistic Lithotripsy Under Percutaneous Nephrolithotomy
10.3969/j.issn.1005-5185.2013.10.010
- VernacularTitle:彩色多普勒超声评价经皮肾镜超声弹道气压碎石术前后肾功能的变化
- Author:
Meng SUN
;
He MENG
;
Lin MA
;
Shuhua ZHANG
;
Yang LIU
;
Hua YANG
- Publication Type:Journal Article
- Keywords:
Ultrasonography,Doppler,color;
Endoscopy;
Air pressure;
Lithotripsy;
Glomerular filtration rate
- From:
Chinese Journal of Medical Imaging
2013;(10):754-757
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To evaluate renal function recovery state with color Doppler ultrasound before and after ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy. Materials and Methods 79 patients with 81 kidneys with upper urinary tract stones underwent ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy, renal parenchymal thickness, renal collecting system separation degree and renal arterial resistance index (RI) were measured with color Doppler ultrasound before and after the operation, subjects were divided into renal dysfunction group (both preoperative and postoperative GFR <20 ml/min, the difference <20 ml/min), renal function significantly improved group (postoperative GFR greater than preoperative, the difference>20 ml/min), renal function significantly impaired group (postoperative GFR less than preoperative GFR, the difference>20 ml/min) and no significant improvement group (both preoperative and postoperative GFR were >20 ml/min, the difference <20 ml/min) according to the preoperative and postoperative glomerular filtration rate (GFR) difference. Renal parenchymal thickness, renal collecting system separation degree and renal artery RI of each group were compared, and their correlation with GFR was analyzed. Results Statistically significant differences (F=129.750, 110.953, 45.411, 18.530, 18.904, 12.565, 27.291, 24.263; P<0.05) were detected in all the four groups between preoperative and postoperative renal parenchymal thickness, renal collecting system separation degree, interlobar renal artery (IRA) and main renal artery (MRA) RI. There was a significant positive correlation (r=0.916, P<0.05) between renal parenchymal thickness and pre-and post-lithotripsy GFR, and a significant negative correlation (r=-0.886,-0.903,-0.923;P<0.05) between renal collecting system separation degree, IRA and MRA RI with pre-and post-lithotripsy GFR. The sensitivity and specificity were 93.4%and 97.3%, respectively when taking renal parenchymal thickness<0.32 cm, renal collecting system separation degree >4.27 cm, IRA RI and MRA RI>0.8 as diagnostic standard for kidney dysfunction; and the sensitivity and specificity were 87.4% and 85.7%respectively when taking IRA RI<0.72 as diagnostic standard for renal function improvement. Conclusion Renal parenchymal thickness <0.32 cm, renal collecting system separation degree >4.27 cm, IRA and MRA RI >0.8, and IRA RI <0.72 can be regarded as clinical reference standard for renal function prognosis of kidney dysfunction and hypo-functional before conducting ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy.
