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肾脏剪切波弹性成像评估肾单位肥大:一项慢性肾脏病的横断面研究

Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease.

作者信息

Iyama Takuji, Takata Tomoaki, Koda Masahiko, Fukuda Satoko, Hoi Shotaro, Mae Yukari, Fukui Takeaki, Munemura Chishio, Isomoto Hajime

机构信息

Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan.

出版信息

J Med Ultrason (2001). 2018 Oct;45(4):571-576. doi: 10.1007/s10396-018-0866-1. Epub 2018 Feb 6.

DOI:10.1007/s10396-018-0866-1
PMID:29411183
Abstract

PURPOSE

To investigate the association of renal elasticity to microscopic findings of nephron hypertrophy and nephrosclerosis.

METHODS

Patients who underwent renal biopsy were enrolled. Renal elasticity was measured by acoustic radiation force impulse, and nephron size (glomerular volume, non-sclerotic glomerular density, and mean profile tubular area) and nephrosclerosis (globally sclerotic glomeruli and interstitial fibrosis) were estimated. Nephron hypertrophy was indicated by larger glomerular volume, larger tubular area, and lower non-sclerotic glomerular density. Nephrosclerosis was indicated by a higher percentage of globally sclerotic glomeruli and higher severity of fibrosis.

RESULTS

Renal elasticity was negatively correlated with glomerular volume (r = - 0.480, P = 0.024) and mean tubular area (r = - 0.469, P = 0.028), but it was not correlated with non-sclerotic glomerular density (r = 0.205, P = 0.359), percentage of globally sclerotic glomeruli (r = 0.057, P = 0.800), and severity of fibrosis (r = 0.014, P = 0.950). In a multiple linear regression analysis, glomerular volume and mean tubular area were independently associated with renal elasticity (std β = - 0.454, P = 0.015 and std β = - 0.577, P = 0.007, respectively).

CONCLUSION

Renal elasticity was correlated with microstructural findings of nephron hypertrophy. Measuring renal elasticity could help in detecting kidney disease.

摘要

目的

研究肾弹性与肾单位肥大及肾硬化微观表现之间的关联。

方法

纳入接受肾活检的患者。采用声辐射力脉冲测量肾弹性,并评估肾单位大小(肾小球体积、非硬化肾小球密度及平均肾小管截面积)和肾硬化情况(全球硬化性肾小球及间质纤维化)。肾小球体积增大、肾小管面积增大及非硬化肾小球密度降低提示肾单位肥大。全球硬化性肾小球百分比升高及纤维化严重程度增加提示肾硬化。

结果

肾弹性与肾小球体积(r = -0.480,P = 0.024)及平均肾小管截面积(r = -0.469,P = 0.028)呈负相关,但与非硬化肾小球密度(r = 0.205,P = 0.359)、全球硬化性肾小球百分比(r = 0.057,P = 0.800)及纤维化严重程度(r = 0.014,P = 0.950)无相关性。在多元线性回归分析中,肾小球体积及平均肾小管截面积与肾弹性独立相关(标准化β分别为 -0.454,P = 0.015及 -0.577,P = 0.007)。

结论

肾弹性与肾单位肥大的微观结构表现相关。测量肾弹性有助于检测肾脏疾病。

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