声辐射力脉冲成像技术对正常肾脏的定量研究

A quantitative study of acoustic radiation force impulse imaging in normal kidney

目的确定正常肾脏各部位弹性系数参考值范围并探讨其影响因素。方法选取380名健康体检者共760个正常肾脏,应用声辐射力脉冲成像技术(ARFI)于不同取样深度下测量正常肾脏皮质、髓质、肾窦剪切波传播速度(Vs)并进行比较,分析受试者性别、年龄、身高、体重、取样深度及取样角度对Vs值的影响。结果垂直取样时正常肾脏皮质、髓质、肾窦Vs值参考值范围分别为(3.33±0.56)、(2.29±0.20)、(1.06±0.19)m/s,且差异有统计学意义(F=29451.58,P<0.05);不同侧别、性别、年龄、体重指数(BMI)、健康体检者正常肾脏皮质、髓质、肾窦同一部位Vs值差异均无统计学意义;不同取样深度测量正常肾脏肾皮质Vs值差异也均无统计学意义;取样线与垂直方向呈30°角时测得正常肾脏皮质、髓质、肾窦Vs值分别为(3.01±0.51)、(2.03±0.21)、(0.96±0.15)m/s,各部位比较差异有统计学意义(F=16033.17,P<0.05);与垂直取样时比较差异也均有统计学意义(t值分别为7.588、2.821、3.946,P均<0.05)。结论 ARFI技术可较客观地测量正常肾脏不同部位Vs值,且影响因素较少,可定量评价正常肾脏不同部位组织弹性顺应性。

Objective To define the reference range of elastic coefficient of different parts of normal kidneys and to investigate the influencing factors.Methods Totally 760 kidneys from 380 healthy people were selected in this study.The shear wave velocities（Vs）of normal renal cortex,renal medulla and renal sinus were measured using acoustic radiation force impulse imaging（ARFI）at different sampling depth.The recorded Vs were compared.The influence of gender,age,height,weight,sampling depth and sampling angle on Vs was analyzed.Results The Vs reference range of normal renal cortex,medulla and sinus at vertical sampling angle was（3.33±0.56）,（2.29±0.20）,and（1.06±0.19）m/s,respectively.The difference was statistically significant（F=29 451.58,P0.05）.When the effects of lateral position,gender,age and body mass index（BMI）on Vs were compared,there was no statistical significance for Vs obtained from the same parts of renal cortex,medulla and sinus of each individual.The Vs of renal cortex was no statistically significant at different sampling depth.When the sampling line was at 30°angle to the vertical direction,the Vs of normal renal cortex,medulla and sinus was（3.01±0.51）,（2.03±0.21）,and（0.96±0.15）m/s,respectively.The difference was statistically significant（F=16 033.17,P0.05）.The Vs obtained from difference parts of kidney at vertical sampling angle were significantly different to the corresponding results obtained when the sampling line was at 30°angle（renal cortex：t=7.588,P0.05,renal medulla：t=2.821,P0.05,renal sinus：t=3.946,P0.05）.Conclusions The ARFI technology can objectively measure the Vs reference range of the different parts of normal kidneys,and meanwhile the Vs value was least influenced by other factors.So it can quantitatively evaluate tissue elasticity of different parts of normal kidneys.