The Value Of The Ultrasound Echo Intensity Of The Renal In The Diagnosis Of Primary Glomerular Disease

Objective:Renal cortical echo intensity was measured by ultrasoundgray-scale quantitative techniques and the changes of renal cortical echointensity of patients with kidney disease were quantitatively analyzed toinvestigate the clinical significance of echo intensity (EI) in the renal cortexwhen diagnosing primary glomerular disease and the diagnostic value ofkidney disease with the ultrasonic gray-scale quantitative techniques.Methods:172patients with primary glomerular disease (Case group) and263normal subjects (control group) were examined by ultrasound andtwo-dimensional ultrasonic grayscale images were collected and quantitativelyanalyzed by ScnImage software, and then echo intensity(EI) obtained. Medicalhistory taking: the general information included gender, age, height, weightand Body Mass Index. The case group information extra included serumcreatinine, blood urea nitrogen,24h urinary protein, serum albumin, serumtotal cholesterol, triglycerides, systolic blood pressure and renal biopsypathology type. Then the general information and renal cortical echo intensityof case group and control group were comparatively analyzed. Simplecorrelation analysis and multiple linear regression analysis between renalcortical echo intensity and indexes(including serum creatinine, blood ureanitrogen,24h urinary protein, serum albumin, serum total cholesterol,triglycerides and systolic blood pressure).30cases selected respectivelyrandomly in the four types of minimal change glomerulonephritis,proliferative sclerosing glomerulonephritis, IgA nephropathy and membranousnephropathy typed by renal biopsy histopathological classification criteria.The four groups numbered as follows: the patient group1, patient group2,patient group3and patient group4. The general information of the fourgroups compared. The renal cortical echo intensity values of control group were compared with each of the four groups.Results: The differences of general information between case group andcontrol group were no significant (P>0.05). The difference of renal corticalecho intensity between case group and normal group was significan(tP<0.05).Renal cortical echo in patients with primary glomerular disease was strongerthan that in control group. There was negative correlation between renalcortical echo intensity and3factors as serum creatinine, blood urea nitrogenand24h urinary protein and no correlation with serum albumin, cholesterol,triglycerides, systolic blood pressure. Renal cortical echo intensityindependently affected by24h urinary protein according to multiple regressionanalysis. The results of variance analysis of multiple sample mean comparisonand pairwise comparisons were: There was positive significance in renalcortical echo intensity difference between control group and each of the casegroup1, case group2, case group3, case group4(P<0.05). It means that therenal cortical echo in four groups of pathological types of primary glomerulardisease was higher than that in control group. The difference of renal corticalecho intensity between case group2and case group1,3,4was significant(P<0.05), in other words patients with proliferative sclerosingglomerulonephritis has higher renal cortical echo than patients' with minimalchange glomerulonephritis, IgA nephropathy and membranous nephropathy.The difference of renal cortical echo between any two of case group1, casegroup3and case group4was no significant (P>0.05), means that, there wasno significant difference of renal cortical echo between any two of the patientswith minimal change glomerulonephritis, IgA nephropathy and membranousnephropathy.Conclusion: The renal cortical echo in the people who suffer primaryglomerular diseases is higher than that in normal ones. It has correlation withserum creatinine, blood urea nitrogen and24h urinary protein (24h urinaryprotein is an independent influencing factor of renal cortical echo), and nocorrelation with serum albumin, cholesterol, triglycerides and systolic bloodpressure. Therefore, early kidney disease increases echogenicity of the renal cortex. The strength of renal cortical echo can be shown by the renal corticalecho quantitative analysis, which reflects subtle changes in kidney tissuestructure and evaluation of renal dysfunction. Echo intensity reflects thechronic damage to the kidneys to a certain extent. Kidney with proliferativesclerosing glomerulonephritis has higher renal cortical echo than that withminimal change glomerulonephritis, IgA nephropathy and membranousnephropathy, but there was no significant difference in the last three. Abovementioned results show that the echo intensity value has correlation with renaldisease and a certain ability to identify the different pathological types ofprimary glomerular diseases. It can reflect the severity of disease and thedegree of damage and provide a reliably diagnostic foundation for clinic. Thisstudy further confirms the profound significance of ultrasonic tissuecharacterization in clinical work, which contains the determination of the echointensity. Quantitative analysis of two-dimensional ultrasonic grayscaleimages enables ultrasound diagnosis more accurate and objective. With thecontinuous development of ultrasound equipment and in-depth study oftechnology of the ultrasonic tissue characterization, determination of echointensity will continue to improve to become major and accurate detectionmethod in Clinical.