Evaluating The Renal Cortex Damage Of Glomerular Disease In Children By Shear Wave Based Elastography Point Quantification

Objective:To evaluate the glomerular disease in children by shear wave based elastography point quantification (ElastPQ) and to discuss the shear wave velocity (SWV) of Renal cortex in normal children at different age.Methods:To choose105cases who was diagnosed with glomerular disease in our hospital during December2013to August2014as research object. All the patients accepted the renal biopsy and confirmed by pathology. In the same time to choose120cases of healthy children who was without kidney disease, autoimmune disease, heart disease, hepatic disease, diabetes, hypertension, obesity, sexual precocity and other medical history as the control group.Use Philips iu Elite ultrasonic diagnostic instrument, which was installed ElastPQ quantitative analysis system, and probe C5-1with1.0-5.0MHz was selected. Use automatic renal biopsy gun and matching Tru-cut needle that produced by the company of Bard.To choose the children who could hold their breath and will do renal biopsy。 At first, all subjects were made routine examination by ultrasound, then applied ElastPQ diagnostic technique, kept the probe vertically downward, the probe under the press of their own weight, instructed patients breathless, made measurement of renal inferior pole cortex of shear wave velocity(SWV) values. All subjects were prone position when we made the examination, we measured both left and right renal that every renal measured5times in the same point, Calculated the average.After the examination we made a record about the urinary protein and hematuria within24hours, then renal biopsy under ultrasound guidance was performed also within24hours. At last, a retrospectively analysis contrast with the pathological results by the renal biopsy.All subjects had a parent accompanied when made the examination, before the examination we won parents’and children’s consent.Atistical analysis:SPSS18.0software was used for statistical analysis. Measurement data were expressed as the mean and standard deviation. Analysis of variance was applied in the intragroup comparison, t-test was applied in the intergroup comparison. Pearson rank correlation test was applied in the correlations. Receiver operator characteristic (ROC) curve analysis to determine the sensitivity and specificity. Taking P<0.05for the difference was statistically significant.Results:1. The age composition of research group and control group has no statistical significance (t=-0.152, P=0.879). The renal cortex SWV value in left and right renal were statistical significance between research group and control group (left renal t=6.896, P=0.000, right renal t=7.415, P=0.000).2. The renal cortex SWV value was positive correlation of UA (left renal r=0.418, P=0.000; right renal r=0.500, P=0.000). the SWV value showed no correlation with hematuria (left renal r=-0.043, P=0.664; right renal r=-0.014, P=0.889).3. The renal cortex SWV value was positive correlation of age in control group (left renal r=0.792, P=0.003; right renal r=0.794, P=0.004).Conclusions:1. SWV value can reflect of renal cortex damage in glomerular disease, and offer a new reference for glomerular disease diagnosis in children.2. The renal cortex SWV value with glomerular disease was positive correlation of UA, as the UA is aggravating, SWV value is higher.3. Between the renal cortex SWV value and age-related was positive correlation in normal children. We should divided groups with age increased that to determine the normal value of the renal cortex SWV in children.