Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Nephrology (Carlton). 2021 Jan;26(1):38-45. doi: 10.1111/nep.13805. Epub 2020 Oct 22.
Renal biopsy is the gold standard for the histological characterization of chronic kidney disease (CKD), of which renal fibrosis is a dominant component, affecting its stiffness. The aim of this study was to investigate the correlation between kidney stiffness obtained by shear wave elastography (SWE) and renal histological fibrosis.
Shear wave elastography assessments were performed in 75 CKD patients who underwent renal biopsy. The SWE-derived estimates of the tissue Young's modulus (YM), given as kilopascals (kPa), were measured. YM was correlated to patients' renal histological scores, broadly categorized into glomerular, tubulointerstitial and vascular scores.
Young's modulus correlates significantly with tubulointerstitial score (ρ = 0.442, P < .001) and glomerular score (ρ = 0.375, P = .001). Patients with no glomerular sclerosis showed lower mean YM measurements compared to those with glomerular sclerosis. The mean YM increased as the percentage of interstitial fibrosis and tubular atrophy increased. The area under the receiver operating characteristic curve (ROC) for SWE in differentiating between mildly and moderately impaired kidneys was 0.702.
Shear wave elastography accurately detects chronic renal damage resulting from glomerular sclerosis, interstitial fibrosis and tubular atrophy, using the optimal cut-off YM value of ≥5.81 kPa.
肾活检是慢性肾脏病（CKD）组织学特征的金标准，其中肾纤维化是主要成分，影响其硬度。本研究旨在探讨剪切波弹性成像（SWE）获得的肾脏硬度与肾脏组织纤维化之间的相关性。
对 75 例接受肾活检的 CKD 患者进行剪切波弹性成像评估。测量组织杨氏模量（YM）的 SWE 衍生估计值，以千帕斯卡（kPa）表示。YM 与患者的肾脏组织学评分相关，广泛分为肾小球、肾小管间质和血管评分。
杨氏模量与肾小管间质评分（ρ=0.442，P<0.001）和肾小球评分（ρ=0.375，P=0.001）显著相关。无肾小球硬化的患者的平均 YM 测量值低于有肾小球硬化的患者。随着间质纤维化和肾小管萎缩百分比的增加，平均 YM 增加。SWE 在区分轻度和中度受损肾脏的受试者工作特征曲线（ROC）下面积为 0.702。
剪切波弹性成像能够准确检测肾小球硬化、间质纤维化和肾小管萎缩引起的慢性肾脏损害，最佳截断值 YM≥5.81kPa。
