声触诊组织定量分析在肾移植术后慢性移植肾肾病诊断中的价值

Value of virtual touch tissue quantification in the diagnosis of chronic allograft nephropathy after renal transplantation

目的探讨声触诊组织定量分析(VTQ)技术在诊断肾移植术后慢性移植肾肾病(CAN)中的价值。方法选择CAN患者28例(CAN组),同期选择肾功能正常的33例移植肾患者为对照组,均进行常规超声检查及VTQ检查,并对检查结果进行对比分析。结果 CAN组剪切波速度(SWV)平均值为(3.03±0.23)m/s,对照组肾实质的SWV平均值为(2.71±0.23)m/s,两者比较差异具有统计学意义(P<0.05);用受试者工作特征(ROC)曲线分析,以SWV≥2.83 m/s为截断值时,诊断CAN的敏感性为92.9%、特异性为66.7%、阳性预测值为70.3%、阴性预测值为91.7%,诊断准确度为78.7%。结论 VTQ可以定量评价移植肾肾实质的弹性变化,并可提供常规超声之外的诊断信息。

Objective To investigate the significance of virtual touch tissue quantification （VTQ） for the assessment of chronic allograft nephropathy （CAN）. Methods A total of 28 patients with CAN were enrolled in the case group, while 33 patients with normal renal function served as the controls. All cases and controls underwent color Doppler sonography and VTQ examination. The results were compared between the two groups. Results The mean shear wave velocity （SWV） of the cases and controls were （ 3.03 ± 0.23 ） m/s and （ 2.71 ±0.23 ） m/s respectively, with statisti- cally significant difference （P 〈 0.05 ）. The receiver operator characteristic （ROC） curve displayed that VTQ value of 2.83 m/s could be used to diagnose CAN; the sensitivity, specificity, positive predictive value and negative predictive value were 92.9%, 66.7%, 70.3% and 91.7%, respectively. The diagnostic accuracy was 78.7%. Conclusion Parenchymal stiffness can be quantitatively measured by VTQ, which can monitor renal function and offer more diag- nostic information than conventional ultrasound examination.