剪切波弹性成像技术对慢性肾脏病的诊断价值  

Value of shear wave elasto-graphy in the diagnosis of chronic kidney disease

作　　者：王黎伟[1] 王志芬[2] 马东红[3] WANG Liwei;WANG Zhifen;MA Donghong(Department of Ultrasound,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;PICC Clinic,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Department of Nephrology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院超声科,河南卫辉453100 [2]新乡医学院第一附属医院PICC门诊,河南卫辉453100 [3]新乡医学院第一附属医院肾脏内科,河南卫辉453100

出　　处：《新乡医学院学报》2025年第1期31-35,共5页Journal of Xinxiang Medical University

基　　金：河南省科技攻关计划项目(编号:LHFJ20220628)。

摘　　要：目的分析剪切波弹性成像技术(SWE)对慢性肾脏病(CKD)的诊断价值。方法选择2022年9月至2023年7月新乡医学院第一附属医院收治的125例CKD患者为研究对象,依据病情分期将其分为CKD 1期组(n=22)、CKD 2期组(n=24)、CKD 3期组(n=26)、CKD 4期组(n=26)、CKD 5期组(n=27)。另选择同时期自愿参加本研究的55例健康志愿者作为对照组。应用彩色多普勒超声诊断仪检测各组受试者肾实质的剪切波速度(SWV)、肾实质像素强度、叶间动脉阻力指数(RI)及肾脏皮质部、髓质部、肾窦部杨氏模量值。采用受试者操作特征(ROC)曲线分析SWE对CKD的诊断价值。结果各分期组CKD患者右肾和左肾皮质SWV、髓质SWV均显著低于对照组,且整体趋势表现为随着病情加重逐渐降低(P<0.05);肾实质像素强度高于对照组,且整体趋势表现为随着病情加重逐渐升高(P<0.05)。各分期组CKD患者肾脏皮质部、髓质部杨氏模量值的平均值、最大值、最小值均显著高于对照组,且整体趋势表现为随着病情加重各数值逐渐升高(P<0.05)。各组受试者肾窦部杨氏模量值比较差异均无统计学意义(P>0.05)。ROC曲线结果显示,肾皮质部杨氏模量值的平均值、最大值、最小值、肾实质像素强度及SWV诊断CKD的曲线下面积分别为0.955、0.920、0.940、0.910、0.858,对CKD均有较佳的诊断价值。结论SWE可协助诊断CKD,且对于患者肾实质病变程度评估有一定参考价值。Objective To analyze the value of shear wave elasto-graphy(SWE)in the diagnosis of chronic kidney disease(CKD).Methods 125 patients with CKD admitted to the First Affiliated Hospital of Xinxiang Medical University from September 2022 to July 2023 were selected and divided into Stage-1 CKD(n=22),Stage-2 CKD(n=24),Stage-3 CKD(n=26),Stage-4 CKD(n=26),and Stage-5 CKD(n=27)groups according to the disease stage.Meanwhile,55 healthy individuals who volunteered to participate in this clinical trial at the same time were selected as the control group.The shear wave velocity(SWV),the pixel intensity of renal parenchyma,the interlobar artery resistance index(RI),and the Young′s modulus values of the renal cortex,medulla and antrum were evaluated.The effect of SWE in the diagnosis of CKD was analyzed by receiver operating characteristic(ROC)curves.Results The SWV values of the right and left renal cortices and medulla of patients in Stage-1,Stage-2,Stage-3,Stage-4,and Stage-5 CKD groups were significantly lower than those in the control group(P<0.05).In general,SWV values decreased gradually with the aggravation of the disease.The pixel intensities of the renal parenchyma of patients in Stage-1,Stage-2,Stage-3,Stage-4,and Stage-5 CKD groups were significantly higher than those in the control group(P<0.05).The pixel intensity of the renal parenchyma increased with the aggravation of the disease in general.The average,maximum,and minimum levels of the Young′s modulus values of the renal cortex and medulla of patients in the Stage-1,Stage-2,Stage-3,Stage-4,and Stage-5 CKD groups were significantly higher than those in the control group(P<0.05).These Young′s modulus values gradually increased with the worsening of the condition.There was no significant difference in the Young′s modulus values of the renal antrum among CKD patients at all stages(P>0.05).ROC curves showed that the areas under the curve of average,maximum,and minimum levels of renal cortex Young′s modulus values,the pixel intensities of the renal parenchy

关 键 词：慢性肾脏病 剪切波弹性成像 肾实质像素强度 叶间动脉阻力指数 杨氏模量值 

分 类 号：R692[医药卫生—泌尿科学]