声触诊组织定量分析技术无创性评价慢性肾病的应用价值

Noninvasive evaluation of chronic kidney disease by virtual touch tissue quantification imaging

目的:应用声触诊组织定量技术(Virtual touch tissue quantification,VTQ)探讨慢性肾病(CKD)患者肾实质弹性变化。方法:选取107例不同临床分期CKD患者和20例健康志愿者,应用VTQ技术测量双肾实质剪切波传播速度(Shear wave velocity,SWV)并进行比较,分析CKD患者肾实质组织弹性变化与临床分期、血肌酐水平变化的相关性。结果:CKD 2期、3期、4期、5期患者肾实质剪切波速度(SWV)明显低于1期患者及正常对照组,差异有统计学意义(P<0.001);慢性肾病4期、5期患者肾实质SWV与1期、2期、3期患者比较差异有统计学意义(P<0.05);CKD 4期与5期之间,2期与3期之间,1期与正常对照组之间比较,肾实质SWV差异无统计学意义(P值分别为0.996,0.339,0.139);CKD患者肾实质SWV值与临床分期、血肌酐水平呈负相关关系(r=-0.596,-0.458;P均<0.001)。结论:VTQ能够量化反映肾实质组织弹性硬度变化,有望成为无创性定量评估CKD肾实质功能损害的新指标。

Objective： To evaluate virtual touch tissue quantification （VTQ） imaging in chronic kidney disease. Methods： VTQ, given shear wave velocity（SWV）, of the renal parenchyma was measured in 107 patients with chronic kidney disease and 20 healthy volunteers. The mean SWV measurements were compared in different stage groups and control volunteers. Correla- tions between SWV measurements and clinical stage or serum creatinine were investigated. Results： The mean SWV in stage 2, stage 3, stage 4 and stage 5 patients with chronic kidney disease were significantly lower than that in stage 1 and volun- teer groups （P〈0.001）; There were significant differences between stage 4, stage 5 vs stage 1, stage 2 and stage 3 patient groups （P〈0.05）; SWV did not differ significantly in stage 4 vs stage 5, stage 2 vs stage 3, and stage 1 vs control volunteers （P=0.996, 0.339, 0.139, respectively）. The mean SWV of renal parenchyma were negatively correlated with clinical stage（Spear- man r=-0.596, P〈0.001） and serum creatinine（Pearson r=-0.458, P〈0.001）. Conclusions： VTQ imaging is a promising noninva- sire technique for evaluation renal elasticity in chronic kidney disease patients.