声触诊组织定量分析技术在肾移植患者肾纤维化评估中的潜在价值  

Potential Value of Virtual TouchTissues Quantification in the Evaluation of Renal Fibrosis in Renal Transplant Patients

作　　者：陈锐[1] 罗燕华[1] 祝志敏[1] 张文静[1] 陈菲[1] 邱少东[1] 黄式文[1] 李又福[1] 曾碧丹[1] CHEN Rui;LUO Yanhua;ZHU Zhimin;ZHANG Wenjing;CHEN Fei;QIU Shaodong;HUANG Shiwen;LI Youfu;ZENG Bidan(Department of Ultrasonic,The 2nd Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510260,China)

机构地区：[1]广州医科大学附属第二医院超声科

出　　处：《中国医疗设备》2019年第8期89-92,96,共5页China Medical Devices

基　　金：2014广东省科技计划项目(2014A020212686)

摘　　要：目的探讨声触诊组织定量分析(Virtual Touch Tissues Quantification,VTQ)技术在移植肾不同程度纤维化患者的差异及其临床意义。方法选取我院于2015年1月至2018年1月期间收治的140例疑似移植肾纤维化患者为研究对象,所有患者均行VTQ检测,以病理学诊断为金标准,绘制受试者工作特征(Receiver Operating Characteristic,ROC)曲线,比较移植肾纤维化不同程度患者的VTQ值及其诊断价值。结果无纤维化组VTQ值、eGFR、SWV与轻度纤维化组相比均无显著性差异(P>0.05),重度纤维化组VTQ值、eGFR、SWV显著高于轻度、中度和无纤维化组(P<0.05),中度纤维化组VTQ值、eGFR、SWV显著高于轻度纤维化组(P<0.05),四组患者的测量深度均无显著性差异(P>0.05)。VTQ值、SWV值与移植肾纤维化程度之间呈高度正相关(Spearman r=0.796、0.774,P<0.001),eGFR与移植肾纤维化程度之间呈高度负相关(Spearman r=-0.889,P<0.001)。移植肾轻度纤维化及以上分期ROC曲线下面积为0.865(95%CI,0.768~0.964);将2.69 m/s作为VTQ值的截断值,敏感度为92.9%,特异度为82.1%;对中度纤维化及以上分期ROC曲线下面积为0.938(95%CI,0.887~0.987),以3.12 m/s为截断值,敏感度为86.1%,特异度为94.4%;重度纤维化ROC曲线下面积为0.957(95%CI,0.895~0.994)。结论声触诊组织定量分析技术检测移植肾纤维化程度具有较高的灵敏度和特异性,对于移植肾纤维化的筛查和诊断具有重要临床应用价值。Objective To investigate the difference and clinical significance of virtual touch tissues quantification(VTQ)in patients with fibrosis of different degrees after kidney transplantation.Methods A total of 140 patients with suspected renal fibrosis admitted to our hospital from January 2015 to January 2018 were enrolled.All patients underwent VTQ test.Pathological diagnosis was used as the gold standard to map the subjects.The receiver operating characteristic curve(ROC)was used to compare the VTQ values of patients with different degrees of renal fibrosis and their diagnostic value.Results There were no significant differences in VTQ,eGFR,and SWV between the non-fibrotic group and the mild fibrotic group(P>0.05).The VTQ value,eGFR and SWV in the severe fibrotic group were significantly higher than those in the mild,moderate and non-fibrotic group(P<0.05).The VTQ value,eGFR and SWV in the moderate fibrotic group were significantly higher than those in the mild fibrotic group(P<0.05).There was no significant difference in the measured depth of the four groups(P>0.05).There was a high positive correlation between VTQ value,SWV value and degree of renal fibrosis(Spearman r=0.796,0.774,P<0.001),and there was a high negative correlation between eGFR and the degree of renal fibrosis(Spearman r=-0.889,P<0.001).The area under ROC curve of mild fibrosis and above grades was 0.865(95%CI,0.768~0.964).Using 2.69 m/s as the cutoff value,the sensitivity is 92.9%and the specificity is 82.1%.The area under ROC curve of moderate fibrosis and above grades was 0.938(95%CI,0.887~0.987).Using 3.12 m/s as the cutoff value,the sensitivity is 86.1%and the specificity is 94.4%.The area under the ROC curve of severe fibrosis was 0.957(95%CI,0.895~0.994).Conclusion The virtual touch tissues quantification(VTQ)technique has high sensitivity and specificity to detect the degree of fibrosis of transplanted kidney,which has important clinical application value for the screening and diagnosis of fibrosis of transplanted kidney.

关 键 词：移植肾 纤维化程度 组织定量分析技术 临床价值 

分 类 号：R814.42[医药卫生—影像医学与核医学] R815.6[医药卫生—放射医学]