应用剪切波弹性成像技术定量评估肝硬化患者的肾组织变化。
Quantitative evaluation of renal tissue changes in patients with liver cirrhosis by shear wave elastography.
机构信息
Department of Ultrasonography, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, The Third Hospital of Shanxi Medical University, 99 Longcheng Street, Taiyuan City, 030032, Shanxi Province, China.
出版信息
Abdom Radiol (NY). 2023 Jun;48(6):2085-2090. doi: 10.1007/s00261-023-03881-6. Epub 2023 Mar 21.
PURPOSE
Hepatocirrhotic nephropathy progresses rapidly and has a poor prognosis, and early detection of renal changes in patients with cirrhosis is particularly important for its prevention and treatment. The objective of this study was to evaluate the value of shear wave elastography (SWE) in the early diagnosis of hepatocirrhotic nephropathy.
METHODS
206 hepatic cirrhosis patients with normal conventional renal function were enrolled and divided into Child-Pugh grade A (Group A), Child-Pugh grade B (Group B), and Child-Pugh grade C (Group C) according to the Child-Pugh grading method. Meanwhile, 60 healthy volunteers matched in age and sex were selected as the control group. The maximum Young's modulus (Emax), average Young's modulus (Emean), and minimum Young's modulus (Emin) of the left renal parenchyma were measured by SWE in all subjects. The Emax, Emean, and Emin values of the left renal parenchyma were compared between the cirrhosis and control groups.
RESULTS
The Emax, Emean, and Emin values of left renal parenchyma in cirrhosis group were higher than those in control group (p = 0.00, 0.00, 0.00). The Emax, Emean, and Emin values of left renal parenchyma in cirrhosis group B and group C were higher than those in control group (p = 0.00, 0.00, 0.00; p = 0.00, 0.00, 0.00), but these values in cirrhosis group A were not significantly different from control group(p = 0.48, 0.52, 0.92). Comparison of the Emax, Emean, and Emin values in left renal parenchyma of three cirrhosis groups, the values of Group B and Group C were higher than those of Group A (p = 0.00, 0.00, 0.00; p = 0.00, 0.00, 0.00), and there was no significant difference between Group B and Group C (p = 0.71, 0.18, 0.39).
CONCLUSION
SWE can detect renal tissue damage in patients with liver cirrhosis earlier than changes identified during routine laboratory examination by quantitatively measuring the elastic parameters of renal parenchyma and may become a new method for early diagnosis of hepatorenal syndrome.
目的
肝硬化肾病进展迅速，预后不良，早期发现肝硬化患者的肾脏变化对其预防和治疗尤为重要。本研究旨在评估剪切波弹性成像（SWE）在肝硬化性肾病早期诊断中的价值。
方法
本研究纳入 206 例常规肾功能正常的肝硬化患者，根据Child-Pugh 分级方法分为 A 级（A 组）、B 级（B 组）和 C 级（C 组）。同时，选择 60 名年龄和性别相匹配的健康志愿者作为对照组。采用 SWE 测量所有受试者左肾实质的最大杨氏模量（Emax）、平均杨氏模量（Emean）和最小杨氏模量（Emin）。比较肝硬化组与对照组左肾实质 Emax、Emean 和 Emin 值。
结果
肝硬化组左肾实质 Emax、Emean 和 Emin 值均高于对照组（p=0.00，0.00，0.00）。肝硬化 B 组和 C 组左肾实质 Emax、Emean 和 Emin 值均高于对照组（p=0.00，0.00，0.00；p=0.00，0.00，0.00），但 A 组与对照组差异无统计学意义（p=0.48，0.52，0.92）。比较三组肝硬化患者左肾实质 Emax、Emean 和 Emin 值，B 组和 C 组高于 A 组（p=0.00，0.00，0.00；p=0.00，0.00，0.00），B 组和 C 组之间差异无统计学意义（p=0.71，0.18，0.39）。
结论
SWE 可以通过定量测量肾实质弹性参数，更早地检测出肝硬化患者的肾组织损伤，可能成为早期诊断肝肾综合征的新方法。
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