Bob Flaviu, Bota Simona, Sporea Ioan, Sirli Roxana, Popescu Alina, Schiller Adalbert
Departments of Nephrology (F.B., A.S.) and Gastroenterology and Hepatology (S.B., I.S., R.S., A.P.), Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania.
J Ultrasound Med. 2015 Apr;34(4):649-54. doi: 10.7863/ultra.34.4.649.
The aim of the study was to establish the relationship between the estimated glomerular filtration rate (GFR) and kidney shear wave speed values assessed by acoustic radiation force impulse (ARFI) elastography.
Our study included 104 patients with or without chronic kidney disease in which the kidney shear wave speed was evaluated by ARFI elastography and correlated with the estimated GFR. Five ARFI measurements were performed in the parenchyma of each kidney. A median value expressed as meters per second was calculated.
Five valid ARFI elastographic measurements were obtained in the right kidney in all patients and in the left kidney in 97.1% of patients. The mean kidney shear wave speed values ± SD in the right and left kidneys were similar: 2.17 ± 0.81 versus 2.06 ± 0.75 m/s (P = .30). The mean kidney shear wave speed decreased with the decrease in the estimated GFR. Statistically significant differences were obtained only when kidney shear wave speed values obtained in patients with an estimated GFR of greater than 90 mL/min/1.73 m(2) were compared to values in patients with stage 4 (estimated GFR, 15-29 mL/min/1.73 m(2)) and stage 5 (estimated GFR, <15 mL/min/1.73 m(2)) chronic kidney disease: 2.32 ± 0.83 versus 1.62 ± 0.75 m/s (P = .03) and 2.32 ± 0.83 versus 1.66 ± 0.72 m/s (P = .04), respectively. For a cutoff value of 2.26 m/s or lower, kidney shear wave speed had 86.7% sensitivity, 48.3% specificity, a 22.1% positive predictive value, and a 95.6% negative predictive value (area under the receiver operating characteristic curve, 0.692; P = .008) for predicting the presence of an estimated GFR of less than 30 mL/min/1.73 m(2).
Kidney shear wave speed values obtained by ARFI elastography decrease with the decrease in the estimated GFR.
本研究旨在确定通过声辐射力脉冲（ARFI）弹性成像评估的估计肾小球滤过率（GFR）与肾脏剪切波速度值之间的关系。
我们的研究纳入了104例患有或未患有慢性肾脏病的患者，通过ARFI弹性成像评估肾脏剪切波速度，并将其与估计的GFR进行相关性分析。对每个肾脏的实质进行5次ARFI测量。计算以米每秒表示的中位数。
所有患者的右肾均获得5次有效的ARFI弹性成像测量值，97.1%的患者左肾获得测量值。右肾和左肾的平均肾脏剪切波速度值±标准差相似：分别为2.17±0.81和2.06±0.75米/秒（P = 0.30）。平均肾脏剪切波速度随估计GFR的降低而降低。仅当将估计GFR大于90 mL/min/1.73 m²的患者的肾脏剪切波速度值与4期（估计GFR，15 - 29 mL/min/1.73 m²）和5期（估计GFR，<15 mL/min/1.73 m²）慢性肾脏病患者的值进行比较时，才获得统计学上的显著差异：分别为2.32±0.83与1.62±0.75米/秒（P = 0.03）和2.32±0.83与1.66±0.72米/秒（P = 0.04）。对于2.26米/秒或更低的截断值，肾脏剪切波速度对于预测估计GFR小于30 mL/min/1.73 m²的存在具有86.7%的敏感性、48.3%的特异性、22.1%的阳性预测值和95.6%的阴性预测值（受试者工作特征曲线下面积，0.692；P = 0.008）。
通过ARFI弹性成像获得的肾脏剪切波速度值随估计GFR的降低而降低。
