声辐射力脉冲成像对小儿紫癜性肾炎损害程度的初步观察

Pilot study of the damage degree of Henoch-Schonlein purpura nephritis on children with acoustic radiation force impulse imaging

目的探讨声辐射力脉冲成像技术（ARFI）对小儿紫癜性肾炎（HSPN）病理损害程度的评估价值。方法将50例健康对照组归为A组；58例HSPN患儿按病理分级分为3组：B组（Ⅰ～Ⅱ级）、C组（Ⅲ级）、D组（Ⅳ～Ⅵ级）。对各组肾皮质行ARFI技术检查，并记录各组肾皮质的剪切波传播速度（SWV），比较各组SWV的差异。结果HSPN患儿肾皮质SWV值明显高于对照组（t=5．883，P=0．017），两两比较发现Ⅳ～Ⅵ级（D组）与其他各组比较差异均具有统计学意义（P〈O．05）；根据ROC曲线可知，当曲线下最大面积为0．719时，SWV截点值为2．59m／s，其诊断HSPN肾损害的敏感性为63％，特异性为67％。结论ARFI技术有望作为评价HSPN病理损害程度的一项有意义指标，并可用于远期随访监测。

Objective To assess the value of acoustic radiation force impulse （ARFI） imaging in the pathological damage of Henoch-Schonlein purpura nephritis on children by comparison with renal biopsy.Methods 50 cases of healthy control group as group A; 58 children with HSPN were divided into three groups according to pathological grading： Ⅰ～Ⅱ class （group B）, Ⅲ级 class （group C） and Ⅳ～Ⅵ class （group D ）. ARFI was then used to measure the shear wave veloeities（SWV） of renal cortex of each group, compared the differences SWV of each group. Results SWV values of children＇s renal cortex with HSPN were significantly higher （ t = 5. 883, P = 0. 017） than those in the group A. Pairwise comparisons found that there were statistically significant differences between group D and the other three groups （ P〈0.05）.According the ROC curve,the cut-off value of SWV was 2.59 m/s when the maximum area under the curve equal to 0. 719, the sensitivity and specificity were 63% and 67%. Conelusions ARFI technology can quantify the elastic properties of the kidney, which is expected as an important indicator to evaluate the pathological extent of damage of the HSPN.