中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2013年
11期
965-969
,共5页
超声检查%肾小球肾炎,IgA%声辐射力脉冲成像
超聲檢查%腎小毬腎炎,IgA%聲輻射力脈遲成像
초성검사%신소구신염,IgA%성복사력맥충성상
Ultrasonopgraphy%Glomerulonephritis,IgA%Acoustic radiation force impulse
目的 探讨声辐射力脉冲成像(acoustic radiation force impulse,ARFI)技术评价IgA肾病肾小管萎缩及间质纤维化程度的应用价值.方法 对肾功能异常的IgA肾病者1 17例、正常对照组80例行常规超声及ARFI检查.记录剪切波传播速度(shear wave velocities,SWV)、血流动力学参数及肾穿刺活检病理结果,将多项参数进行对比分析.通过量化肾皮质弹性,评价其在早期提示肾功能损害方面的优越性.结果 ①IgA肾病组皮质、髓质SWV均比正常对照组对应区域的SWV小,差异有统计学意义(P＜0.05),集合系统SWV在两组间比较差异无统计学意义.②肾皮质SWV提示早期肾功能损害的临界值为2.7 cm/s,诊断准确率为71％,优于叶间动脉阻力指数的准确率61.9％.③慢性肾病(CKD)肾功能分期的1、2、3、4期肾皮质SWV逐渐减小,而5期SWV较4期增大.④依据IgA肾病牛津分型肾小管萎缩及间质纤维化程度(T)分为T0、T1、T2三型,T2型皮质SWV与T0、T1型比较,差异有统计学意义(P＜0.05).结论 ARFI技术通过量化肾组织的弹性,能够区分IgA肾病牛津分型中肾小管萎缩及间质纤维化的程度,早期提示IgA肾病肾功能异常并判断临床分期,诊断早期肾损害的敏感性、特异性、准确率较高.
目的 探討聲輻射力脈遲成像(acoustic radiation force impulse,ARFI)技術評價IgA腎病腎小管萎縮及間質纖維化程度的應用價值.方法 對腎功能異常的IgA腎病者1 17例、正常對照組80例行常規超聲及ARFI檢查.記錄剪切波傳播速度(shear wave velocities,SWV)、血流動力學參數及腎穿刺活檢病理結果,將多項參數進行對比分析.通過量化腎皮質彈性,評價其在早期提示腎功能損害方麵的優越性.結果 ①IgA腎病組皮質、髓質SWV均比正常對照組對應區域的SWV小,差異有統計學意義(P＜0.05),集閤繫統SWV在兩組間比較差異無統計學意義.②腎皮質SWV提示早期腎功能損害的臨界值為2.7 cm/s,診斷準確率為71％,優于葉間動脈阻力指數的準確率61.9％.③慢性腎病(CKD)腎功能分期的1、2、3、4期腎皮質SWV逐漸減小,而5期SWV較4期增大.④依據IgA腎病牛津分型腎小管萎縮及間質纖維化程度(T)分為T0、T1、T2三型,T2型皮質SWV與T0、T1型比較,差異有統計學意義(P＜0.05).結論 ARFI技術通過量化腎組織的彈性,能夠區分IgA腎病牛津分型中腎小管萎縮及間質纖維化的程度,早期提示IgA腎病腎功能異常併判斷臨床分期,診斷早期腎損害的敏感性、特異性、準確率較高.
목적 탐토성복사력맥충성상(acoustic radiation force impulse,ARFI)기술평개IgA신병신소관위축급간질섬유화정도적응용개치.방법 대신공능이상적IgA신병자1 17례、정상대조조80례행상규초성급ARFI검사.기록전절파전파속도(shear wave velocities,SWV)、혈류동역학삼수급신천자활검병리결과,장다항삼수진행대비분석.통과양화신피질탄성,평개기재조기제시신공능손해방면적우월성.결과 ①IgA신병조피질、수질SWV균비정상대조조대응구역적SWV소,차이유통계학의의(P＜0.05),집합계통SWV재량조간비교차이무통계학의의.②신피질SWV제시조기신공능손해적림계치위2.7 cm/s,진단준학솔위71％,우우협간동맥조력지수적준학솔61.9％.③만성신병(CKD)신공능분기적1、2、3、4기신피질SWV축점감소,이5기SWV교4기증대.④의거IgA신병우진분형신소관위축급간질섬유화정도(T)분위T0、T1、T2삼형,T2형피질SWV여T0、T1형비교,차이유통계학의의(P＜0.05).결론 ARFI기술통과양화신조직적탄성,능구구분IgA신병우진분형중신소관위축급간질섬유화적정도,조기제시IgA신병신공능이상병판단림상분기,진단조기신손해적민감성、특이성、준학솔교고.
Objective To investigate the value of acoustic radiation force impulse (ARFI) on evaluating the renal tubular atrophy and interstitial fibrosis of IgA nephropathy(IgAN).Methods 117 patients diagnosed with IgAN,and 80 normal cases were examined with conventional ultrasonography and ARFI,recording the shear wave velocities(SWV),the hemodynamics and the renal biopsy results to quantify the elastic changes of renal cortex,with the aim of assessing AFRI's advantages on early diagnosing the impair of kidney.Results The SWV value of renal cortex,renal medulla of IgAN group were smaller than that of normal group (P ＜0.05),while the collective system SWV value had no difference(P ＞0.05).According to the ROC curve,the cut-off value of SWV in renal cortex was 2.7 cm/s.The accuracy of the diagnosis was 71 ％,which was better than RI (61.9％).The SWV value of the renal cortex decreased with the different stage of 1,2,3,4,but stage 5 was larger than stage 4.The degree of renal tubular atrophy and interstitial fibrosis(T) can be classified by the SWV of renal cortex,and the SWV of T2 was larger than T1 (P ＜0.05).Conclusions By quantifying the elastic change of kidney,ARFI technology is able to distinguish the degree of renal tubular atrophy and interstitial fibrosis,diagnose renal impairment early and judge the clinical stages.Furthermore the sensitivity,specificity,accuracy of it are superior to hemodynamic.
