Preliminary Study Of Renal Elasticity Changes In Patients With Diabetic Nephropathy By Virtual Touch Tissues Quantification Technology

Objective:To detect diabetic nephropathy patient’s kidney elasticity changes during early periods by Acoustic radiation force impulse techniques, and compare with pathological biopsy results, then evaluate the clinical reference value about VTQ techniques for renal damage in diabetic nephropathy patients.Methods:To choose who was diagnosed with diabetes in our hospital during May2012to July2013. According to Mogensen stage of DN, selected II-IV phase as inclusion criteria, and accepted the renal biopsy, confirmed by pathology of54patients with DN as the research object. The control group,50cases of healthy adults without kidney disease, diabetes, autoimmune diseases and hepatitis, hypertension, heart disease and other medical history.Use Siemens ACUSON S2000ultrasonic diagnostic instrument, which was installed VTQ quantitative analysis system. All subjects were made the two-dimensional ultrasound first, then applied ARFI diagnostic technique, kept the probe vertically downward, the probe under the pressure of their own weight, instructed patients breathless, pressed the "update" key, made measurement of renal cortex and medulla and sinus of transverse shear wave velocity (SWV) values.Every part repeatedly measured the effective measurements at least five times, Calculated the average. Kept the distance between the probe and each ROI<5.5cm. Then made a record about the blood glucose, renal function, urinary protein, et al,in the same day, record the measured values. At last, made a retrospectively analysis contrast with the pathological results by the renal biopsy under ultrasound guidance.Results:(1) The SWV value of observation group and control group in the renal cortex and medulla and renal sinus area are characterized by renal cortex> renal medulla area> the renal sinus area.(2) The renal cortex SWV value with the increase of UA, gradually reduce, differences between Ⅱ and Ⅲ～Ⅳ period, the control group and Ⅲ～Ⅳ period were statistically significant; Renal medulla area and renal sinus area while also showed a trend of decrease, but there is no statistical significance in this study.(3) The critical value of the renal cortex SWV value between Ⅱ～Ⅲ period was2.46m/s, it’s specificity is about81.3%, sensitivity is about83.3%, to distinguish DN Ⅱ and Ⅲ period.Conclusions:(1) VTQ technology to detect SWV value can quantify reflect elasticity of kidney, the renal cortex> the renal medulla area> the renal sinus area. (2) Renal cortex SWV value with DN to be inversely associated with the degree of renal damage, as the illness is aggravating, SWV value is lower.(3) VTQ technology to detect SWV value can quantify reflect the degree of kidney damage in early DN to a certain extent, and offer a new reference for DN early diagnosis.