Chen Jiaxin, Wang Shuqing, Wu Qunyan, Li Liujun, Pi Songying, Su Zhongzhen, Lin Yuhong
Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
The First Affiliated Hospital of University of South, Hengyang, China.
Abdom Radiol (NY). 2025 Mar;50(3):1266-1272. doi: 10.1007/s00261-024-04613-0. Epub 2024 Oct 10.
The purpose of this study was to explore the value of Doppler ultrasound imaging and shear wave elastography (SWE) in evaluating renal interstitial fibrosis/tubular atrophy (IFTA).
During April 2019 and November 2023, biopsy-proven IgA nephropathy (IgAN) patients were enrolled in our study. Conventional ultrasound, Doppler ultrasound imaging and SWE measurements were performed, and related parameters were collected. According to the Oxford classification of IgAN, interstitial fibrosis/tubular atrophy (T) lesions were grouped into T0, T1 and T2 group. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic accuracy of SWE in identifying IFTA.
A total of 100 IgAN patients were enrolled in the final cohort. 67 patients were in the T0 group, and 33 patients were in the T1/T2 group. The average SWE values were 42.17 ± 9.11 kPa in the T0 group and 36.83 ± 10.32 kPa in the T1/T2 group (p = 0.01). Multivariate logistic regression revealed that the SWE value and end diastolic velocity (EDV) of the interlobar artery were found to be independent risk factors for IFTA. For the diagnosis of IFTA, the area under the ROC curve (AUC) of SWE alone was 0.652, whereas the AUC of SWE in combination with the EDV was 0.807 (p = 0.008).
The combination of Doppler ultrasound imaging and SWE measurements could improve the diagnostic performance of quantitative assessment of IFTA in IgAN patients.
本研究旨在探讨多普勒超声成像和剪切波弹性成像（SWE）在评估肾间质纤维化/肾小管萎缩（IFTA）中的价值。
2019年4月至2023年11月期间，将经活检证实的IgA肾病（IgAN）患者纳入本研究。进行常规超声、多普勒超声成像和SWE测量，并收集相关参数。根据IgAN的牛津分类，将间质纤维化/肾小管萎缩（T）病变分为T0、T1和T2组。构建受试者操作特征（ROC）曲线，以评估SWE在识别IFTA中的诊断准确性。
最终队列共纳入100例IgAN患者。T0组67例，T1/T2组33例。T0组的平均SWE值为42.17±9.11kPa，T1/T2组为36.83±10.32kPa（p=0.01）。多因素逻辑回归显示，叶间动脉的SWE值和舒张末期速度（EDV）是IFTA的独立危险因素。对于IFTA的诊断，单独SWE的ROC曲线下面积（AUC）为0.652；而SWE与EDV联合的AUC为0.807（p=0.008）。
多普勒超声成像和SWE测量相结合可提高IgAN患者IFTA定量评估的诊断性能。
