Value of Contrast-Enhanced Ultrasound,Serum Creatinine,and Urea Nitrogen Levels in the Diagnosis of Renal Parenchymal Injury Caused by Pediatric Urinary Tract Infections
10.13241/j.cnki.pmb.2025.14.017
- VernacularTitle:超声造影与血清肌酐及尿素氮水平在儿科泌尿系感染所致肾实质损伤诊断中的价值
- Author:
Xu CHEN
1
;
Chen-xia ZHU
;
Yi-chun XIAO
;
Wei WU
;
Ye LU
Author Information
1. 无锡市儿童医院超声医学科 江苏无锡 214200
- Publication Type:Journal Article
- Keywords:
Contrast-enhanced ultrasound;
Serum creatinine;
Urea nitrogen;
Pediatric urinary tract infection;
Renal parenchymal injury
- From:
Progress in Modern Biomedicine
2025;25(14):2371-2377
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early diagnostic value of contrast-enhanced ultrasound(CEUS)combined with serum creatinine(Scr)and urea nitrogen(BUN)in children with renal parenchymal injury caused by urinary tract infections(UTIs).Methods:A total of 120 children with UTIs admitted from January 2020 to January 2025 were selected and divided into a renal parenchymal injury group(n=65)and a non-injury group(n=55)based on the results of 99mTc-DMSA renal static imaging.All children underwent CEUS examination within 24 hours of admission to obtain hemodynamic parameters of the renal cortex and medulla(time-to-peak[TTP],peak intensity[PI],and area under the curve[AUC]),and Scr and BUN levels were measured.Multivariate logistic regression analysis was used to identify independent risk factors,and the diagnostic efficacy was evaluated using receiver operating characteristic(ROC)curves.Results:In the renal parenchymal injury group,Scr(0.82±0.25 vs 0.53±0.15 mg/dL),BUN(16.23±4.82 vs 12.42±3.27 mg/dL),and cortical TTP(51.47±12.38 vs 43.45±12.55 s)were significantly elevated,while cortical PI(32.63±6.37 vs 39.23±7.31 dB)and AUC(2915.36±536.37 vs 3415.35±681.5 dB·s)were significantly decreased(all P＜0.05).Multivariate analysis showed that Scr(OR=6.17),BUN(OR=2.58),cortical TTP(OR=1.98),and PI(OR=0.60)were independent predictors.In the ROC curve analysis,the combination of CEUS parameters(cortical TTP,PI,AUC)with Scr and BUN demonstrated the best diagnostic efficacy(AUC=0.953,sensitivity 87.3％,specificity 90.3％).Conclusion:CEUS can sensitively identify renal parenchymal injury associated with UTIs by dynamically assessing abnormal renal cortical blood perfusion.When combined with Scr and BUN,it significantly improves diagnostic accuracy,providing an important basis for early intervention and renal function protection in children with UTIs.
