剪切波弹性成像与磁共振在儿童梗阻性肾脏疾病肾实质损害评估中的对比分析  

Analysis of Shear Wave Elastography and Magnetic Resonance for Renal Parenchymal Damage Assessment in Children with Obstructive Kidney Disease

作　　者：蒋映丰[1] JIANG Ying-feng(Department of Ultrasound Imaging.Haikou People's Hospital of Central South University,Haikou 570208,Hainan Province,China)

机构地区：[1]中南大学附属海口市人民医院超声影像科,海南海口570208

出　　处：《中国CT和MRI杂志》2020年第7期91-93,103,F0003,共5页Chinese Journal of CT and MRI

基　　金：海南省医药卫生科研项目(编号:15A200067)。

摘　　要：目的分析超声剪切波弹性成像(SWE)结合磁共振技术在评估儿童梗阻性肾脏疾病发生肾实质损害中的应用价值。方法选择2016年01月至2018年01月入我院诊断先天性肾积水患儿共40例,其中梗阻型15例,非梗阻型25例,另选择30例健康儿童。均接受SWE检测双侧肾脏中部肾皮质与髓质的杨氏模量值,磁共振尿路成像(MRU)和弥散加权成像(DWI)检测尿路狭窄和表观弥散系数(ADC),血清肌酐计算肾小球滤过率(GFR)。结果肾积水组患侧肾皮质与髓质的杨氏模量值均明显高于健侧和健康组,校正ADC值和GFR值降低,差异有统计学意义(P<0.05)。高度肾积水组患侧与轻中度肾积水组患侧、梗阻型积水组患侧与非梗阻型积水组患侧相比,肾皮质与髓质的杨氏模量值升高,校正ADC值和GFR值降低,差异有统计学意义(P<0.05)。Pearson检验得出,肾皮质和髓质的杨氏模量值与GFR值呈负相关(P<0.05),校正ADC值与GFR值呈正相关(P<0.05)。结论 SWE结合磁共振技术在评估儿童梗阻性肾脏疾病发生肾实质损害中有较好的应用价值。Objective To study the values of shear wave elastography(SWE) combined with magnetic resonance for renal parenchymal damage assessment in children with obstructive kidney disease. Methods A total of 40 children as congenital hydronephrosis from January 2016 to January 2018, 15 of obstructive type, other 25 of non-obstructive type, 30 healthy children were enrolled. They all received SWE for Young’s modulus of cortex and medulla in bilateral middle kidneys, urinary stricture and apparent diffusion coefficient(ADC) by magnetic resonance urography(MRU) and diffusion weighted imaging(DWI), glomerular filtration rate(GFR) calculated with serum creatinine. Results The Young’s modulus values of cortex and medulla in affected kidneys in hydronephrosis group were significantly higher than non-affected side and healthy group, corrected ADC and GFR values lower, too(P<0.05). They were the same to affected kidneys in high hydronephrosis group than mild to moderate hydronephrosis group, affected kidneys in obstructive group than nonobstructive group(P<0.05). It was negative correlation between Young’s modulus of cortex and medulla and GFR(P<0.05), positive correlation between corrected ADC and GFR values(P<0.05) by Pearson text. Conclusion It canbring applicated value of SWE combined with magnetic resonance for renal parenchymal damage assessment in children with obstructive kidney disease.

关 键 词：剪切波弹性成像 磁共振尿路成像 弥散加权成像 梗阻性肾脏疾病 肾实质 表观弥散系数 肾小球滤过率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.9[医药卫生—诊断学]