剪切波弹性成像技术定量评估慢性肾病分期的应用价值  

Quantitative evaluation in the stage of chronic nephrosis by shear-wave elasticity technology

作　　者：王倩[1] 艾红[1] 张茜茜[1] 淡敏[1] 李宁[1] 潘文倩[1] 任晓萍[1] 

机构地区：[1]西安交通大学第一附属医院超声科,710061

出　　处：《中华超声影像学杂志》2014年第5期414-418,共5页Chinese Journal of Ultrasonography

摘　　要：目的 探讨剪切波弹性成像（shear-wave elasticity,SWE）技术对慢性肾病定量分期的诊断价值.方法 对60例慢性肾病患者（肾病组）与同期20例健康体检者（对照组）应用SWE技术检测肾实质弹性,并检测肾功能指标,比较SWE测值与肾功能指标对慢性肾病分期的诊断价值.结果 将20例健康对照组归为R0期,60例肾病组根据肾功能分为R1～R4期.肾病组各组间（除R1与R2期之间外）及与对照组杨氏模量值比较,差异均有统计学意义（P＜0.01）;根据ROC曲线可知,当曲线下最大面积为0.886时,杨氏模量截点值为5.53 kPa,其诊断慢性肾病的灵敏性、特异性分别为81.70％、80.40％.杨氏模量值和尿素氮、胱抑素C均与慢性肾病分期存在正相关性.杨氏模量值和尿素氮、胱抑素C诊断≥R3期的ROC曲线下面积分别为0.965、0.950、0.965,=R4期的ROC曲线下面积分别为0.978、0.912、0.961.结论 SWE技术通过量化肾组织的弹性,为慢性肾病分期提供了一种新的定量评估指标.Objective To investigate the diagnostic value of the shear-wave elasticity （SWE） imaging technology on the quantitative diagnosis of chronic nephrosis stage.Methods Sixty patients with nephrosis （nephrosis group） were evaluated with SWE and the renal function test.The Young＇s modulus value and the renal function were measured,and the results were compared with those of twenty healthy subjects （control group）.Results Twenty cases of healthy control group were definited as R0.Sixty patients of nephrosis group were divided into four groups according to renal function：R1-R4.The Young＇s modulus of the nephrosis group was significantly higher than the control group （P 〈0.01）.There were also statistically significant differences among each stage of the nephrosis group （except R1 and R2 of nephrosis group）（P 〈 0.01）.According the ROC curve,the cut-off value of the Young＇s modulus was 5.53 kPa when maximum area under the curve equal to 0.886,the sensitivity and specificity were 81.70% and 80.40%.The Young＇s modulus value and renal function were positively correlated with the stage of nephrosis.The areas under the ROC curves for the Young＇s modulus,urea nitrogen and csytatin C were 0.965,0.950,0.965 for ≥R3,0.978,0.912,0.961 for =R4,respectively.Conclusions SWE imaging technology provided a new quantitative index for the stage of nephrosis through quantizing the elasticity of the tissue.

关 键 词：超声检查 肾病 剪切波弹性成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]