声脉冲辐射力成像技术定量评价肾功能不全患者肾脏纤维化临床研究  

Preliminary Clinical Research on Quantitative Evaluating the Nephritic Fibrosis in Renal Insufficiency Patients by Acoustic Radiation Force Impulse Imagine

作　　者：詹嘉[1] 朱隽[1] 朱绫琳[1] 柴启亮[1] 王海尔[1] 陈悦[1] 

机构地区：[1]复旦大学附属华东医院超声科,上海市200040

出　　处：《中国超声医学杂志》2012年第8期748-751,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨声脉冲辐射力成像技术(ARFI)检测肾功能不全的价值。方法使用超声的声脉冲辐射力成像技术检测261例受检者右肾皮质,包括对照组122例、疑似肾功能不全而行肾穿刺活检的患者81例和已经确诊尿毒症的行血液透析治疗的患者58例。比较肾穿刺组患者剪切波速度Vs与穿刺病理结果。结果三组受检者的右肾皮质剪切波速度(Vs)相互之间有显著差异(P<0.05),随着肾脏纤维化程度的加重,Vs增加。Vs对诊断肾功能不全患者的ROC曲线下面积为0.85,分别以Vs 1.64 m/s,1.75 m/s作为肾功能不全诊断界值,诊断的敏感度、特异度分别为74%、91%;84%、81%。结论声脉冲辐射力成像技术可无创反映肾脏组织的弹性硬度,间接评估肾纤维化,具有潜在的临床应用价值。Objective To investigate the value of Acoustic Radiation Force Impulse （ARFI） in predicting the nephritic fibrosis of renal insufficiency patients. Methods ARFI technique was used to examine the right renal cortex in 261 cases. All cases were divided into three groups： normal control （healthy people without any history of kidney dis eases） 122 cases, suspected renal insufficiency （thus acquired a biopsy to confirm） 81 cases, uremia （underwent hemodialysis） 63 cases. The shear wave velocity（SWV） based on ARFI technique was achieved in all cases and compared in three groups. Results The SWV was significantly different in normal controls, suspected renal insufficiency and uremia groups （P〈0. 01）. The SWV in the right renal cortex increased along with the degree of kidney fibrosis. The area under the receiver operating curve （ROC） of the SWV value was 0.85 compared with kidney biopsy pathologic re suits. Taking 1.64 m/s and 1.75 m/s as the threshold, the diagnostic sensitivity and specificity are 74% and 91%; 84% and 81% respectively. Conclusions ARFI technique reflects the stiffness of the renal parenchyma, which is po tentially valuable in predicting renal fibrosis clinically.

关 键 词：声脉冲辐射力 肾功能不全 肾纤维化 肾脏活检 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]