李硕,刘婷,刘晓明,胡小丽
LI Shuo,LIU Ting,LIU Xiaoming,HU Xiaoli

• 1:贵州医科大学附属医院超声中心
• 2:贵州医科大学医学影像学院

摘要(Abstract)：

目的 探讨超微血流成像技术(SMI)及剪切波弹性成像技术(SWE)在慢性肾脏病(CKD)分期诊断中的应用价值。方法 87例CKD患者分为早期(1～2期，n=42)组和晚期(3～5期，n=45),收集2组CKD患者入院时的一般临床资料[性别、年龄及体质量指数(BMI)]、相关实验室检查指标[肾小球滤过率(GFR)、血清肌酐(Scr)、尿素氮(BUN)及胱抑素C(cystatin-C)],采用彩色多普勒超声诊断仪行SMI及SWE检测，记录2组CKD患者肾脏大小轮廓、肾皮质厚度及回声、肾脏皮质血流充盈分级及杨氏模量值，采用ROC曲线评估SMI和SWE单独及联合检测对CKD分期的诊断效能。结果 晚期组CKD患者血流分级、杨氏模量值水平高于CKD早期组，差异均有统计学意义(P<0.05);CKD患者杨氏模量值、血流分级分别与GFR呈负相关(P<0.001);SMI、SWE及联合超声技术在CKD不同分期下的诊断效能以2者联合曲线下面积(AUC)最高(0.71)。结论 SMI及SWE联合检测对CKD患者分期诊断具有重要应用价值。
Objective To explore the application value of superb microvascular imaging(SMI) and shear wave elastography(SWE) in diagnosing the stages of chronic kidney disease(CKD). Methods A total of 87 patients with CKD were divided into early stage(stage 1-2, n=42) and late stage(stage 3-5, n=45). General clinical data [gender, age and body mass index(BMI)] and CKD-related laboratory indicators [glomerular filtration rate(GFR), serum creatinine(Scr), urea nitrogen(BUN) and cystatin C] of 2 groups of patients with CKD at admission were collected. Color Doppler ultrasonography was used to detect SMI and SWE, record the kidney size contour, renal cortex thickness and echo, the grading of renal cortex blood flow filling and Young's modulus values of two groups of the patients with CKD. ROC curve was applied to assess the diagnostic efficacy of SMI and SWE alone and their combination for staging CKD. Results The blood flow grading and Young's modulus values of the patients with CKD were higher in late stage group than those in early stage group(P<0.05). Young's modulus value and blood flow grading of the patients with CKD were negatively correlated with GFR(P<0.001). Among SMI, SWE and combined ultrasound techniques, the diagnostic efficacy of combined ultrasound techniques at different stages of CKD was the highest, with AUC(0.71). Conclusion The detection of SMI combined with SWE has an important application value in diagnosing stages of patients with CKD.

关键词(KeyWords)： 肾小球滤过率;慢性肾脏病;剪切波弹性成像;超微血流成像;杨氏模量值;实验室检查
glomerular filtration rate;chronic kidney disease;shear wave elastography;superb microvascular imaging;young's modulus;laboratory examination

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生健康委科学技术基金项目(gzwkj2023-068)

作者(Author): 李硕,刘婷,刘晓明,胡小丽
LI Shuo,LIU Ting,LIU Xiaoming,HU Xiaoli

DOI: 10.19367/j.cnki.2096-8388.2024.08.016

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