Leong Sook Sam, Wong Jeannie Hsiu Ding, Md Shah Mohammad Nazri, Vijayananthan Anushya, Jalalonmuhali Maisarah, Ng Kwan Hoong
Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia.
Ultrasound Med Biol. 2019 Jun;45(6):1417-1426. doi: 10.1016/j.ultrasmedbio.2019.01.024. Epub 2019 Apr 5.
The purpose of this study was to assess the potential of shear wave elastography (SWE) as an indicator of abnormal kidney function defined by radiolabeled glomerular filtration rate (GFR). Fifty-seven patients referred for Cr-ethylenediaminetetraacetic acid GFR and Tc-dimercaptosuccinic acid renal scintigraphy were included. Young's modulus (YM) measured with SWE and kidney length, volume, cortical thickness and parenchymal echogenicity measured with conventional ultrasound were correlated with patients' GFR and renal scintigraphy results. Spearman correlation coefficients between SWE and GFR were negative for the right (r = -0.635, p < 0.0001) and left (r = -0.817, p < 0.0001) kidneys. Positive correlations between left renal cortical thickness (r = 0.381, p = 0.04) and left kidney volume (r = 0.356, p = 0.019) with GFR were reported. SWE correctly predicted the dominant functioning kidney in 94.7% of cases. The area under the receiver operating characteristic curve for SWE (0.800) was superior to that for conventional ultrasound (0.252-0.415). The cutoff value of ≥5.52 kPa suggested a kidney function ≤60 mL/min/1.73 m (82.4% sensitivity and 76.2% specificity). SWE has advantages over conventional ultrasound in assessing kidney function and distinguishing the dominant functioning kidney.
本研究的目的是评估剪切波弹性成像(SWE)作为由放射性标记的肾小球滤过率(GFR)定义的肾功能异常指标的潜力。纳入了57例因进行铬-乙二胺四乙酸GFR和锝-二巯基丁二酸肾闪烁显像而就诊的患者。用SWE测量的杨氏模量(YM)以及用传统超声测量的肾脏长度、体积、皮质厚度和实质回声与患者的GFR和肾闪烁显像结果相关。SWE与GFR之间的Spearman相关系数在右肾(r = -0.635,p < 0.0001)和左肾(r = -0.817,p < 0.0001)均为负相关。报告显示左肾皮质厚度(r = 0.381,p = 0.04)和左肾体积(r = 0.356,p = 0.019)与GFR呈正相关。SWE在94.7%的病例中正确预测了主要功能肾。SWE的受试者工作特征曲线下面积(0.800)优于传统超声(0.252 - 0.415)。≥5.52 kPa的临界值表明肾功能≤60 mL/min/1.73 m²(敏感性为82.4%,特异性为76.2%)。在评估肾功能和区分主要功能肾方面,SWE比传统超声具有优势。