CAJ | 학술논문

目的探讨剪切波弹性成像(shear-wave elasticity,SWE)技术对慢性肾病定量分期的诊断价值.方法对60例慢性肾病患者(肾病组)与同期20例健康体检者(对照组)应用SWE技术检测肾实质弹性,并检测肾功能指标,比较SWE测值与肾功能指标对慢性肾病分期的诊断价值.结果将20例健康对照组归为R0期,60例肾病组根据肾功能分为R1～R4期.肾病组各组间(除R1与R2期之间外)及与对照组杨氏模量值比较,差异均有统计学意义(P＜0.01);根据ROC曲线可知,当曲线下最大面积为0.886时,杨氏模量截点值为5.53 kPa,其诊断慢性肾病的灵敏性、特异性分别为81.70％、80.40％.杨氏模量值和尿素氮、胱抑素C均与慢性肾病分期存在正相关性.杨氏模量值和尿素氮、胱抑素C诊断≥R3期的ROC曲线下面积分别为0.965、0.950、0.965,=R4期的ROC曲线下面积分别为0.978、0.912、0.961.结论 SWE技术通过量化肾组织的弹性,为慢性肾病分期提供了一种新的定量评估指标.
목적 탐토전절파탄성성상(shear-wave elasticity,SWE)기술대만성신병정량분기적진단개치.방법 대60례만성신병환자(신병조)여동기20례건강체검자(대조조)응용SWE기술검측신실질탄성,병검측신공능지표,비교SWE측치여신공능지표대만성신병분기적진단개치.결과 장20례건강대조조귀위R0기,60례신병조근거신공능분위R1～R4기.신병조각조간(제R1여R2기지간외)급여대조조양씨모량치비교,차이균유통계학의의(P＜0.01);근거ROC곡선가지,당곡선하최대면적위0.886시,양씨모량절점치위5.53 kPa,기진단만성신병적령민성、특이성분별위81.70％、80.40％.양씨모량치화뇨소담、광억소C균여만성신병분기존재정상관성.양씨모량치화뇨소담、광억소C진단≥R3기적ROC곡선하면적분별위0.965、0.950、0.965,=R4기적ROC곡선하면적분별위0.978、0.912、0.961.결론 SWE기술통과양화신조직적탄성,위만성신병분기제공료일충신적정량평고지표.
Objective To investigate the diagnostic value of the shear-wave elasticity (SWE) imaging technology on the quantitative diagnosis of chronic nephrosis stage.Methods Sixty patients with nephrosis (nephrosis group) were evaluated with SWE and the renal function test.The Young's modulus value and the renal function were measured,and the results were compared with those of twenty healthy subjects (control group).Results Twenty cases of healthy control group were definited as R0.Sixty patients of nephrosis group were divided into four groups according to renal function:R1-R4.The Young's modulus of the nephrosis group was significantly higher than the control group (P ＜0.01).There were also statistically significant differences among each stage of the nephrosis group (except R1 and R2 of nephrosis group)(P ＜ 0.01).According the ROC curve,the cut-off value of the Young's modulus was 5.53 kPa when maximum area under the curve equal to 0.886,the sensitivity and specificity were 81.70％ and 80.40％.The Young's modulus value and renal function were positively correlated with the stage of nephrosis.The areas under the ROC curves for the Young's modulus,urea nitrogen and csytatin C were 0.965,0.950,0.965 for ≥R3,0.978,0.912,0.961 for =R4,respectively.Conclusions SWE imaging technology provided a new quantitative index for the stage of nephrosis through quantizing the elasticity of the tissue.