Goya Cemil, Kilinc Faruk, Hamidi Cihad, Yavuz Alpaslan, Yildirim Yasar, Cetincakmak Mehmet Guli, Hattapoglu Salih
1 Department of Radiology, Dicle University School of Medical Science, Yenisehir, Diyarbakir, Turkey.
AJR Am J Roentgenol. 2015 Feb;204(2):324-9. doi: 10.2214/AJR.14.12493.
OBJECTIVE. The goal of this study is to evaluate the changes in the elasticity of the renal parenchyma in diabetic nephropathy using acoustic radiation force impulse imaging. SUBJECTS AND METHODS. The study included 281 healthy volunteers and 114 patients with diabetic nephropathy. In healthy volunteers, the kidney elasticity was assessed quantitatively by measuring the shear-wave velocity using acoustic radiation force impulse imaging based on age, body mass index, and sex. The changes in the renal elasticity were compared between the different stages of diabetic nephropathy and the healthy control group. RESULTS. In healthy volunteers, there was a statistically significant correlation between the shear-wave velocity values and age and sex. The shear-wave velocity values for the kidneys were 2.87, 3.14, 2.95, 2.68, and 2.55 m/s in patients with stage 1, 2, 3, 4, and 5 diabetic nephropathy, respectively, compared with 2.35 m/s for healthy control subjects. Acoustic radiation force impulse imaging was able to distinguish between the different diabetic nephropathy stages (except for stage 5) in the kidneys. The threshold value for predicting diabetic nephropathy was 2.43 m/s (sensitivity, 84.1%; specificity, 67.3%; positive predictive value, 93.1%; negative predictive value 50.8%; accuracy, 72.1%; positive likelihood ratio, 2.5; and negative likelihood ratio, 0.23). CONCLUSION. Acoustic radiation force impulse imaging could be used for the evaluation of the renal elasticity changes that are due to secondary structural and functional changes in diabetic nephropathy.
目的。本研究的目的是使用声辐射力脉冲成像评估糖尿病肾病患者肾实质弹性的变化。对象与方法。本研究纳入了281名健康志愿者和114名糖尿病肾病患者。在健康志愿者中，基于年龄、体重指数和性别，使用声辐射力脉冲成像通过测量剪切波速度对肾脏弹性进行定量评估。比较糖尿病肾病不同阶段与健康对照组之间肾脏弹性的变化。结果。在健康志愿者中，剪切波速度值与年龄和性别之间存在统计学显著相关性。1、2、3、4和5期糖尿病肾病患者肾脏的剪切波速度值分别为2.87、3.14、2.95、2.68和2.55 m/s，而健康对照者为2.35 m/s。声辐射力脉冲成像能够区分肾脏不同的糖尿病肾病阶段（5期除外）。预测糖尿病肾病的阈值为2.43 m/s（敏感性，84.1%；特异性，67.3%；阳性预测值，93.1%；阴性预测值50.8%；准确性，72.1%；阳性似然比，2.5；阴性似然比，0.23）。结论。声辐射力脉冲成像可用于评估糖尿病肾病继发结构和功能变化所导致的肾脏弹性变化。
