Clinical Application Of Acoustic Pulse Force Imaging In Children With Henoch–sch?nlein Purpura Nephritis

ObjectiveThis study applies Virtual Touch tissue quantification(VTQ)technology to detect the SWV of children with Henoch–Sch?nlein purpura nephritis(HSPN),children with Henoch–Sch?nlein purpura(HSP)and healthy children,discuss the differences between the three groups of SWV values.Then analyse the relationship between the SWV value of children with HSPN and renal pathology,24 hours urine protein.To explore the clinical value of VTQ in the diagnosis and evaluation of renal injury in children with HSPN.Methods46 children hospitalized with HSPN from October 2015 to December 2016 in the First Affiliated Hospital of Zhengzhou University were selected as the HSPN group and all the children confirmed by renal biopsy.Select 15 cases of children with primary allergic purpura and urine normal as the HSP group,20 healthy children were selected as the normal control group,and collected all the clinical data and laboratory information.A1l the children underwent routine ultrasound examination and the examinationof the VTQ technology.The children with HSPN underwent renal biopsy at 1 weeks after VTQ technique,and the renal tissues were examined by light microscopy,immunofluorescence and electron microscopy.46 children with HSPN were divided into two groups according to pathological grading:I ~ II class(group A),III ~ IV class(group B),and the children of Ⅴ,Ⅵclass were 0,receiver operating characteristic curve was established by the two groups’ data.According to 24 hours urine protein the46 children were divided into trace or mild proteinuria group,moderate proteinuria group and severe proteinuria group.Then correlation analysis was made between renal SWV and pathological grading,24 hours urine protein in children with HSPN.Results1.The SWV value of renal cortex in the HSPN group was(2.78±0.39)m/s,the HSP group was(2.31±0.21)m/s,and the normal control group was(2.16±0.17)m/s.Three groups of SWV value of the comparison,HSPN group and HSP group,HSPN group and normal control group difference was statistically significant(P<0.05),HSP group and normal control group SWV value was not statistically significant(P>0.05).2.Correlation analysis between SWV value and renal pathological grading(r=0.423,P=0.003),there was statistically significant and positive correlation between them,the SWV value greater,the higher the pathological level.3.Correlation analysis between SWV value and glomerular lesions,renal tubular interstitial lesions,24 h urine protein quantitative,there were no statistically significant(P> 0.05),namely there was no significant correlation between SWV value and glomerular crescents formation,renal tubular interstitial lesions,quantitative proteinuria.4.The HSPN group and control group SWV values were compared and established the ROC curve,the maximum area under the curve(AUC)was 0.916,the cut-off value of SWV was 2.37m/s,the sensitivity was 85.4%,specificity was 81.2%.5.The HSPN SWV values of A and B two groups were compared and established the ROC curve,the maximum area under the curve(AUC)was 0.791,the cut-off value of SWV was 2.60 m/s,the sensitivity was 64.9%,specificity was 77.8%.Conclusions1.Virtual touch tissue quantification(VTQ)can be srapid,noninvasive and quantitativee measure the renal elasticity of children with HSPN.There was a positive correlation between SWV values of renal cortex and renal pathology,the higher the SWV value,suggesting that the more severe kidney damage,the higher the pathological level.2.Compared with conventional ultrasound,VTQ technique is more sensitive and specific in diagnosing renal injury.3.VTQ technology is expected to be a new sensitive indicator for the detection of renal damage in children with HSPN and to assess the degree of renal injury,and provide help for clinical diagnosis and treatment.