| 李奇默,董晓秋,梁越,李岩,姚金来.剪切波弹性成像及超声造影定量评估慢性肾脏病[J].中国医学影像技术,2023,39(7):1051~1055 |
| 剪切波弹性成像及超声造影定量评估慢性肾脏病 |
| Shear wave elastic imaging and contrast-enhanced ultrasound for quantitative evaluation of chronic kidney disease |
| 投稿时间：2023-02-17 修订日期：2023-03-16 |
| DOI：10.13929/j.issn.1003-3289.2023.07.023 |
| 中文关键词: 肾功能不全,慢性 超声检查 前瞻性研究 |
| 英文关键词:renal insufficiency, chronic ultrasonography prospective studies |
| 基金项目: |
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| 中文摘要: |
| 目的 观察剪切波弹性成像(SWE)及超声造影(CEUS)定量评估慢性肾脏病(CKD)的价值。方法 纳入168例CKD患者(CKD组,包括CKD1期48例、CKD2期46例、CKD3期38例、CKD4~5期36例)和50名肾脏正常受试者(对照组),行常规超声、SWE及CEUS,比较组间及不同分期CKD之间各超声参数的差异。采用Pearson相关性分析观察CKD患者SWE、CEUS参数与肾功能指标的相关性。绘制受试者工作特征曲线,评估SWE和CEUS参数单独及联合诊断CKD的效能。结果 CKD组肾脏最大长径、最大宽径、皮质厚度、时间-强度曲线(TIC)绝对峰值强度(ΔPI)及TIC下面积(Area)均小于对照组(P均<0.05),平均(Emean)、最大(Emax)及最小弹性模量(Emin)均高于对照组(P均<0.05)。CKD组内,随CKD分期增高,肾脏Emean、Emax及Emin增高,TIC的ΔPI及Area缩小(P均<0.05)。CKD组肾脏Emean、Emax、Emin与肌酐、尿酸、尿素氮均呈正相关(r:0.12~0.44,P均<0.05);Area与肌酐、尿酸、尿素氮均呈负相关(r=-0.44、-0.31、-0.43,P均<0.05),ΔPI与肌酐、尿酸均呈负相关(r=-0.15、-0.18,P均<0.05)。以肾脏Emean、Emax、Emin、Area及ΔPI诊断CKD的曲线下面积(AUC)为0.776~0.882,尤以Area及Emean诊断价值更高,其联合诊断CKD的AUC达0.949,敏感度为92.63%,特异度为90.71%。结论 SWE及CEUS均可有效诊断CKD;二者联合可进一步提高诊断价值。 |
| 英文摘要: |
| Objective To observe the value of shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) for quantitative evaluation of chronic kidney disease (CKD). Methods Totally 168 patients with CKD (CKD group, including 48 cases of CKD1 stage, 46 cases of CKD2 stage, 38 cases of CKD3 stage and 36 cases of CKD4-5 stages) and 50 subjects with normal kidney (control group) were enrolled. Conventional ultrasound, SWE and CEUS were performed, and the ultrasonic parameters were compared between groups and among different stages of CKD. Pearson correlation analysis was used to explore the correlations of SWE, CEUS parameters and renal function indexes in CKD patients. Subject operating characteristic curves were plotted to evaluate the efficacy of SWE and CEUS parameters alone and in combination for diagnosing CKD. Results The maximum length diameter, the maximum width diameter, cortical thickness of kidney, peak intensity (ΔPI) of time intensity curve (TIC) and area under TIC (Area) in CKD group were lower than those in control group (all P<0.05), while the mean, the maximum and the minimum elastic modulus (Emean, Emax and Emin) in CKD group were higher than those in control group (all P<0.05). In CKD group, with the increase of CKD stage, renal Emean, Emax and Emin increased, but ΔPI and Area decreased (all P<0.05). Renal Emean, Emax and Emin were positively correlated with creatinine, uric acid and urea nitrogen in patients with CKD (r:0.12-0.44, all P<0.05), while the area was negatively correlated with creatinine, uric acid and urea nitrogen (r=-0.44, -0.31, -0.43, all P<0.05) and ΔPI was negatively correlated with creatinine and uric acid (r=-0.15, -0.18, both P<0.05). The area under the curve (AUC) of kidney Emean, Emax, Emin, Area and ΔPI for diagnosing CKD was 0.776-0.882. Both Area and Emean had higher diagnostic value, AUC of their combination for diagnosing CKD was 0.949, with sensitivity of 92.63% and specificity of 90.71%. Conclusion Both SWE and CEUS could be used to diagnose CKD effectively. Combination of SWE and CEUS could further improve the diagnostic value. |
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