声触诊组织定量技术在慢性肾病应用的影响因素:肾-脾对比研究

Factors Affecting the Application of Virtual Touch Tissue Quantification Technique in Chronic Kidney Disease: a Spleen-kidney Comparative Study

目的探讨声触诊组织定量技术在慢性肾病应用的影响因素。方法选取2011年9月1日至2012年4月30日在北京协和医院行肾活检的慢性肾病患者62例。在相同体位下,使用声触诊组织定量技术测量患者的左肾皮质及同一深度脾脏实质的组织弹性,各测量15次。计算每例患者肾脏弹性测值的变异系数,并与脾脏测值对比,分析测量次数、测量深度、慢性肾病病理诊断及临床分期对肾脏弹性测值变异度水平的影响。结果测量次数的增加不能减低肾脏及脾脏的测值变异系数(P>0.05),但是可以增加测量均值的稳定性(P=0.000)。肾脏测值变异系数与测量深度呈正相关(r=0.370,P=0.003),而脾脏测值变异系数与测量深度无显著相关性(P>0.05)。慢性肾病分期及病理诊断与肾脏测值变异系数无显著相关性(P>0.05)。结论采用声触诊组织定量技术测量肾组织弹性时,需要在方法学上建立更为细致而统一的规范,以提高测量结果的稳定性。

Objective To study the methodological factors that influence the application of virtual touchtissue quantification （ VTQ） technique in chronic kidney disease （ CKD） . Methods A total of 62 CKD patientswho underwent kidney biopsy in Peking Union Medical College Hospital between September 2011 and April 2012were enrolled in this study. Under the same positions, the tissue shear wave velocity （SWV） of left kidney cortexand spleen parenchyma at the same depth were measured with VTQ technique for 15 times, respectively. The coefficient of variation （ CV） was calculated to identify the variability of measurements. With regard to repetitionnumber,measuring depth, pathologic etiology,and CKD stage,their impacts on CV were analyzed and comparedbetween kidney and spleen. Results The CV level did not reduce when the number of measurements increased（P 〉 0. 05 ）,while the stability of mean value of SWV was improved （P = 0. 000） . Kidney CV had a significantly positive correlation with the depth of measurement （ r = 0. 370,P =0. 003 ）,while such a tendency was notobserved in spleen （ P 〉 0. 05 ） . Spearman analysis indicated that neither CKD stage nor pathologic etiologyshowed a significant correlation with kidney CV level （ P 〉 0. 05 ） . Conclusion When VTQ technique is applied to measure the renal tissue elasticity, more standardized methodologies should be developed to improve the stability of measurement results.