Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (8): 1201-1206.doi: 10.3969/j.issn.2095-4344.3054

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Quantitative analysis of renal blood flow perfusion using contrast-enhanced ultrasound in rats with hemorrhagic shock during resuscitation

Zeng Zhen, Hu Jingwei, Li Xuan, Tang Linmei, Huang Zhiqiang, Li Mingxing   

  1. Department of Ultrasound, the First Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • Received:2020-03-17 Revised:2020-03-21 Accepted:2020-05-09 Online:2021-03-18 Published:2020-12-11
  • Contact: Li Mingxing, Chief physician, Department of Ultrasound, the First Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • About author:Zeng Zhen, Master candidate, Physician, Department of Ultrasound, the First Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • Supported by:
    the Scientific Research Project of Sichuan Provincial Department of Education, No. 142A0139

Abstract: BACKGROUND: The amount of renal blood perfusion is often in parallel with renal function. If contrast-enhanced ultrasound (CEUS) can be used to quantitatively analyze changes in renal blood flow perfusion during resuscitation so as to indirectly reflect changes in renal function, this will provide a new way for the clinical assessment of hemorrhagic shock-reperfusion injury of the kidney.
OBJECTIVE: To establish a reperfusion model of severe hemorrhagic shock in Sprague-Dawly rats and to explore the value of CEUS parameters in evaluating renal perfusion.
METHODS: Twenty male Sprague-Dawley rats were randomly divided into four groups, five in each group: sham operation group, and 2-, 6-, and 24-hour hemorrhagic shock reperfusion groups (2-, 6-, and 24-hour HS-R groups). CEUS examination was performed in each group, and the quantitative parameters of peak intensity, time to peak, area under curve, average transit time were checked and obtained. The correlation between time-intensity curve parameters and serum creatinine, urea nitrogen, renal tissue myeloperoxidase, endothelin 1, and prostaglandin E1 levels was analyzed.
RESULTS AND CONCLUSION: Compared with the sham operation group, the pathological injury was significant in the HS-R groups, especially in the HS-R group, with increased peak intensity, time to peak, area under curve, and average transit time (P < 0.05) as well as increased serum creatinine and urea nitrogen levels. There were significant differences in peak arrival time and average transit time among groups. Bivariate Pearson’s correlation analysis showed that time to peak and average transit time were significantly correlated with serum creatinine, urea nitrogen, renal tissue myeloperoxidase, endothelin 1, and prostaglandin E1 levels. To conclude, (1) CEUS can effectively monitor and quantitatively evaluate the renal perfusion changes during the recovery of hemorrhagic shock. (2) Time to peak and average transit time are two indexes of the time-intensity curve with some reference value. (3) After hemorrhagic shock and reperfusion, the kidney injury is aggravated but not alleviated, and the injury is the most serious at 24 hours after resuscitation. (4) CEUS provides a new idea for clinical evaluation of hemorrhagic shock-reperfusion injury of the kidney. 

Key words: kidney, hemorrhagic shock, reperfusion, contrast-enhanced ultrasound, renal function, renal injury, rat

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