| 摘要: |
| 目的 探讨剪切波定量弹性成像技术在慢性肾脏疾病早期诊断中的应用价值。
方法 应用剪切波弹性成像技术采集30例经肾脏穿刺活检为慢性肾脏疾病（CKD）患者及30名正常对照组的左肾皮质部、髓质部及肾窦部杨氏模量最大值Emax及平均值Emean，探讨肾脏不同病变部位其剪切波弹性模量的差异。
结果 1.剪切波弹性测值比较：①正常对照组左肾皮质部Emax为(3.47 ± 0.54) kPa，Emean为（1.87±0.68）kpa，髓质部Emax为(2.45 ± 1.09) kPa，Emean为（1.08±0.68）kpa，肾窦部Emax 为( 9.01 ± 3.74) kPa，Emean为(7.49± 2.77) kPa，髓质、皮质及肾窦部Emax、Emean值均依次逐渐增高，三者间比较均有显著性差异，差异有统计学意义（P＜0.01）。病例组左肾皮质部Emax为(4.12 ± 1.71) kPa，Emean为（2.76±1.06）kpa，髓质部Emax为(2.57 ± 1.07) kPa，Emean为（1.27±0.68）kpa，肾窦部Emax为( 8.76± 2.45) kPa，Emean为(6.78 ± 2.57) kPa，髓质、皮质及肾窦部Emax、Emean变化趋势与正常对照组相同，三者间比较差异有统计学意义(P＜0.05)。②病例组与对照组各组数据对比，病例组Emax、Emean均明显大于对照组，两组间肾皮质部Emax、Emean均有差异，差异有统计学意义（P＜0.05），以皮质部Emean间差异更加显著（P＜0.01）。
2.ROC曲线评价各部位杨氏模量值应用于诊断慢性肾脏疾病的可靠性：皮质部AUROC＞0.7，截断值为3.15kpa时，准确性及特异性良好。
结论 剪切波超声弹性成像可定量评价肾脏不同部位杨氏模量值。慢性肾脏疾病肾脏皮质部硬度变化与病变部位及程度密切相关。SWE定量评价肾脏实质硬度为临床肾脏疾病诊断提供更丰富诊断信息。 |
| 关键词: 超声检查 剪切波超声弹性成像 肾皮质 |
| DOI： |
| 投稿时间：2017-08-04修订日期：2017-10-26 |
| 基金项目: |
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| Quantitative shear-wave ultrasound elasticity imaging in the clinical application of chronic kidney disease |
| hongliu,wangjing |
| (Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) |
| Abstract: |
| Objective To assess the diagnostic value of the technology of Shear-Wave Elasticity (SWE) in early diagnosis of chronic kidney disease (CKD).
Methods Shear-Wave Elasticity imaging were performed in 30 patients with CKD confirmed by biopsy and 30 healthy objects. We got the quantitative elasticity value (Young’s modulus) by SWE in the left kidney cortex, medullary and sinus, and compared.
Results 1.The comparison of elasticity value: ① In the control group, the Emax and Emean of cortex was(3.47±0.54) kPa and(1.87±0.68)kpa, the Emax and Emean of medullary was (2.45±1.09) kPa and (1.08±0.68)kpa, the Emax and Emean of sinus was( 9.01±3.74) kPa and (7.49±2.77) kPa, with statistically significant difference(P＜0.01). In the patient group, the Emax and Emean of cortex was(4.12±1.71)kPa and(2.76±1.06)kpa, the Emax and Emean of medullary was (2.57±1.07) kPa and(1.27±0.68)kpa, the Emax and Emean of sinus was(8.76±2.45) kPa and(6.78±2.57)kPa, with statistically significant difference(P＜0.05).②Comparison the data between the control group and the patient group, the data of Emax and Emean in patient group were significantly greater than the data in the control group, especially the Emean of cortex(P＜0.01).
2. Evaluation the reliability of the elasticity value (Young’s modulus) in diagnosis the CKD by ROC curve: the AUROC of the cortex value＞0.7, and with fine accuracy and specificity by the cut-off point 3.15kpa.
Conclusion Shear-wave ultrasound elasticity imaging can provide quantitative elasticity value of the different part of the kidney, and closely related to the lesion position and degree. SWE with quantitative value can provide more assistance in evaluation kidney elasticity for clinical diagnosis in CKD. |
| Key words: Ultrasonography, Shear-wave ultrasound elasticity imaging, kidney cortex |
