Wu Jingping, Li Guanghan, Liu Jian, Sun Weiliang, Liu Jiang, Zou Guming, Lu Haitao, Zheng Min
Department of Ultrasound Medicine, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.
Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.
Eur Radiol. 2023 Aug;33(8):5625-5633. doi: 10.1007/s00330-023-09507-1. Epub 2023 Feb 27.
The purpose of this study was to investigate the effects of tissue fibrosis and microvessel density on shear wave-based ultrasound elastography (SWUE) of chronic kidney disease (CKD). In addition, we were looking to see whether SWUE could predict stage of CKD, correlating with the histology on kidney biopsy.
Renal tissue sections from 54 patients diagnosed with suspected CKD were subjected to immunohistochemistry (CD31 and CD34), and the degree of tissue fibrosis was assessed using Masson staining. Before renal puncture, both kidneys were examined using SWUE. Comparative analysis was used to assess the correlation between SWUE and microvessel density, and between SWUE and the degree of fibrosis.
Fibrosis area according to Masson staining (p < 0.05) and integrated optical density (IOD) (p < 0.05) were positively correlated with CKD stage. The percentage of positive area (PPA) and IOD for CD31 and CD34 were not correlated with CKD stage (p > 0.05). When stage 1 CKD was removed, PPA and IOD for CD34 were negatively correlated with CKD stage (p < 0.05). Masson staining fibrosis area and IOD were not correlated with SWUE (p > 0.05), PPA and IOD for CD31 and CD34 were not correlated with SWUE (p > 0.05) and, finally, no correlation between SWUE and CKD stage was found (p > 0.05).
The diagnostic value of SWUE for CKD staging was very low. The utility of SWUE in CKD was affected by many factors and its diagnostic value was limited.
• There was no correlation between SWUE and the degree of fibrosis, or between SWUE and microvessel density among patients with CKD. • There was no correlation between SWUE and CKD stage and the diagnostic value of SWUE for CKD staging was very low. • The utility of SWUE in CKD is affected by many factors and its value was limited.
本研究旨在探讨组织纤维化和微血管密度对慢性肾脏病（CKD）基于剪切波的超声弹性成像（SWUE）的影响。此外，我们还想了解SWUE是否能够预测CKD分期，并与肾活检的组织学结果相关联。
对54例疑似CKD患者的肾组织切片进行免疫组织化学检查（CD31和CD34），并使用Masson染色评估组织纤维化程度。在肾穿刺前，对双侧肾脏进行SWUE检查。采用对比分析评估SWUE与微血管密度之间以及SWUE与纤维化程度之间的相关性。
根据Masson染色的纤维化面积（p < 0.05）和积分光密度（IOD）（p < 0.05）与CKD分期呈正相关。CD31和CD34的阳性面积百分比（PPA）和IOD与CKD分期无关（p > 0.05）。去除1期CKD后，CD34的PPA和IOD与CKD分期呈负相关（p < 0.05）。Masson染色的纤维化面积和IOD与SWUE无关（p > 0.05），CD31和CD34的PPA和IOD与SWUE无关（p > 0.05），最后，未发现SWUE与CKD分期之间存在相关性（p > 0.05）。
SWUE对CKD分期的诊断价值非常低。SWUE在CKD中的应用受到多种因素影响，其诊断价值有限。
• CKD患者中，SWUE与纤维化程度之间以及SWUE与微血管密度之间均无相关性。• SWUE与CKD分期之间无相关性，SWUE对CKD分期的诊断价值非常低。• SWUE在CKD中的应用受到多种因素影响，其价值有限。
