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用于评估天然肾脏组织硬度的超音速剪切波超声检查法

Supersonic Shear Wave Ultrasonography for Assessing Tissue Stiffness in Native Kidney.

作者信息

Radulescu Daniela, Peride Ileana, Petcu Lucian Cristian, Niculae Andrei, Checherita Ionel Alexandru

机构信息

Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania.

Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania.

出版信息

Ultrasound Med Biol. 2018 Dec;44(12):2556-2568. doi: 10.1016/j.ultrasmedbio.2018.07.001. Epub 2018 Aug 26.

Abstract

Recent years have brought shear wave elastography to the attention of nephrologists as a non-invasive method for detecting kidney fibrosis and, therefore, as a potential tool for reducing the need for kidney biopsy. Few studies are performed on native kidney. We aimed to compare cortical stiffness, assessed by measuring Young's modulus (YM, kPa) with SuperSonic Imaging technology, in patients with various degrees of chronic kidney disease (CKD) compared with healthy individuals. Cortical stiffness was measured by two operators, in different sessions, in 32 patients with CKD stages 3-5 and 20 healthy individuals. Comparison between mean YM values in CKD and those in controls and also between the different stages of CKD was our primary objective. The influence of other possible confounders on YM readings was also investigated and analyzed. Mean YM was significantly greater in CKD patients than in controls. Estimated YM was not able to differentiate the stages of CKD, except stage 5. Intra-subject variability was greater in CKD than in controls. Body mass index was the most important confounder in multiple analyses, in both the CKD and control groups. Our results highlight a positive correlation between increased cortical stiffness and presence of CKD. Further studies are needed to validate this method for implementation in daily clinical practice.

摘要

近年来,剪切波弹性成像作为一种检测肾纤维化的非侵入性方法,从而成为一种减少肾活检需求的潜在工具,引起了肾病学家的关注。针对正常肾脏开展的研究较少。我们旨在通过使用超声成像技术测量杨氏模量(YM,千帕斯卡)来评估皮质硬度,比较不同程度慢性肾脏病(CKD)患者与健康个体之间的差异。由两名操作人员在不同时段对32例3 - 5期CKD患者和20名健康个体测量皮质硬度。我们的主要目标是比较CKD患者与对照组的平均YM值,以及CKD不同阶段之间的平均YM值。此外,还研究并分析了其他可能的混杂因素对YM读数的影响。CKD患者的平均YM显著高于对照组。除5期外,估计的YM无法区分CKD的不同阶段。CKD患者的受试者内变异性大于对照组。在多项分析中,体重指数是CKD组和对照组中最重要的混杂因素。我们的结果突出了皮质硬度增加与CKD存在之间的正相关关系。需要进一步研究以验证该方法在日常临床实践中的应用价值。

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