Annals of vascular surgery · 2025
Evaluation of Postoperative Acute Kidney Injury Through Contrast-Enhanced Ultrasound in Patients With Aortic Dissection: An Observational Cohort Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Tian Ju, Zhang Lei, Li Liang, Zhang Yiran, Pu Tianning, Zheng Chao, Fu Jingjing, Wei Yun, Wang Mingyue, Wang Yao, Sun Zhonghua, Yong Qiang, Xu Lei
Аннотация
BACKGROUND: Acute kidney injury (AKI) is a common postoperative complication in patients with aortic dissection (AD). Contrast-enhanced ultrasound (CEUS) quantitatively evaluates kidney microvascular perfusion, but its significance in patients undergoing AD surgery remains unclear. This study examined the correlation between preoperative CEUS parameters and postoperative AKI in patients with AD.
METHODS: This observational cohort study included 90 patients with AD who underwent kidney CEUS and AD surgery. CEUS was performed before surgery, with peak intensity, time-to-peak (TTP), and mean transit time (MTT) derived from the time-intensity curve. The occurrence of postoperative AKI was assessed using the criteria of improving global outcomes in kidney disease. Receiver operating characteristic curves were plotted to determine the predicting value of CEUS parameters for postoperative AKI. Logistic regression analysis was conducted to identify potential risk factors for postoperative AKI in AD patients.
RESULTS: The CEUS parameters TTP (P = 0.001) and MTT (P = 0.010) were significantly longer in the AKI group (n = 30) than in the non-AKI group (n = 60). The area under the receiver operating characteristic curve for TTP and MTT was 0.717 and 0.667 in predicting postoperative AKI, respectively. Multivariate analysis revealed that TTP >5.75 sec and MTT >21.35 sec were independent risk factors for postoperative AKI in AD patients.
CONCLUSION: The CEUS parameters TTP and MTT are independent risk factors for predicting postoperative AKI in patients with AD. CEUS could be used as a valuable tool for identifying patients with AD at risk of developing postoperative AKI and for monitoring the renal perfusion.
METHODS: This observational cohort study included 90 patients with AD who underwent kidney CEUS and AD surgery. CEUS was performed before surgery, with peak intensity, time-to-peak (TTP), and mean transit time (MTT) derived from the time-intensity curve. The occurrence of postoperative AKI was assessed using the criteria of improving global outcomes in kidney disease. Receiver operating characteristic curves were plotted to determine the predicting value of CEUS parameters for postoperative AKI. Logistic regression analysis was conducted to identify potential risk factors for postoperative AKI in AD patients.
RESULTS: The CEUS parameters TTP (P = 0.001) and MTT (P = 0.010) were significantly longer in the AKI group (n = 30) than in the non-AKI group (n = 60). The area under the receiver operating characteristic curve for TTP and MTT was 0.717 and 0.667 in predicting postoperative AKI, respectively. Multivariate analysis revealed that TTP >5.75 sec and MTT >21.35 sec were independent risk factors for postoperative AKI in AD patients.
CONCLUSION: The CEUS parameters TTP and MTT are independent risk factors for predicting postoperative AKI in patients with AD. CEUS could be used as a valuable tool for identifying patients with AD at risk of developing postoperative AKI and for monitoring the renal perfusion.