| Objective: The paper aims to apply the VTQ technology for an early diagnosis of chronic kidney disease. A comparison between VTQ value and blood biochemistry measurement result is done as well. Through the measurement of shearing wave speed in different stages of the chronic kidney disease by VTQ, the damage of kidney is estimated, which provides reference to the disease's stage diagnosis. By studying the relation between VTQ value and renal puncture pathological result, the analysis of correlation between VTQ value and IgA kidney disease Lee classification is conducted, which provides new basis for clinical chronic kidney disease diagnosis.Method: 85 patients were chosen. They were diagnosed chronic kidney disease during November 2010 and March 2011. The control group had 50 normal cases. The ultrasonic instrument was ACUSON S2000 with VTQ technology produced by Siemens. The patients lay on the side or lay on the back. Under the two dimensions ultrasound, the echo of kidney cortex and medulla was observed and the major diameter, the thickness diameter, and the real thickness were measured. Then the blood flow was observed by color Doppler, including maximum blood speed of the kidney artery at the renal hilus, the accelerated speed, and the resistance index. At last, VTQ mode was adopted. A piece of kidney coronary major diameter facet was taken, keeping it vertical to the sound beam's direction. The patients were told to hold the breath. The sound impulse radiation was applied to the solid areas of kidney upper pole, middle pole and lower pole. At least three samples were taken and the mean was calculated as the Vs. The routine biochemistry results were checked when the patients entered the hospital. The renal puncture was processed in tow ways of light microscope and immunofluorescence.Result: The analysis showed that the VTQ values of two kidneys of the control group had no statistical discrepancy. The VTQ value of the left kidney was 3.22±0.34m/s and that for the right kidney was 3.22±0.32m/s. The VTQ values of two kidneys of the control group were obviously higher than those of the CKD group(P<0.05). The comparison between the control group and CKD group in regard with the value at each stage showed that there was significant difference of the two groups in stage1, stage2, stage 3, stage 4, and stage 5 (P<0.05). The comparison between each stage value of CKD group showed that CKD stage1 had significant difference with CKD stage 2, stage 3, stage 4, and stage 5; CKD stage2 had significant difference with CKD stage 3, stage 4 and stage 5; CKD stage 3 has significant difference with CKD stage 4 and stage 5; but CKD stage 4 had no significant difference with CKD stage 5. The correlation analysis showed that VTQ value had negative correlation with Scr and BUN. The kidney disease can be diagnosed at early stage by VTQ. The comparison between chronic kidney diseases with different pathology showed that their VTQ values had no significant difference. The research on IgA kidney disease concluded that the more serious of the glomeruli of the kidney disease, the smaller of the VTQ value. They had significant negative correlation.Conclusion: VTQ technology can diagnose the kidney disease at early stage through the measurement of shearing wave speed and the analysis of kidney cortex elasticity. It is more sensitive than the routine blood biochemistry examination. It is valuable for the diagnosis of kidney disease in different stages. The VTQ value of the kidney cortex area is highly correlated with the glomeruli of the kidney disease. Therefore, VTQ technology, as a non-invasive method, is valuable for the clinical chronic kidney disease diagnosis. |
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