Value Of Quantitative Analysis By Ultrasonic Elastography Tissue Diffusion To Assess Chronic Kidney Function Impairment

Objective: To investigate the application value in the quantitative analysis of ultrasonic elastography and tissue diffusion for evaluating the degree of chronic kidney function impairment.Methods: 31 healthy persons as control group and CKD group included 146 cases of clinical diagnosis of chronic glomerulonephritis(CGN) as experimental group were selected from the Affiliated Zhongshan Hospital of Dalian University between June, 2014 and December, 2015. The former were collected from health examinations and the later were collected either from outpatients or inpatients from the above hospital and were served as experimental group which was subdivided into five smaller groups according glomerular filtration rate(GFR) results: CKD1(30 cases), CKD2(29 cases), CKD3(31cases), CKD4(31 cases) and CKD5 group(25 cases). Based on two-dimensional and color Doppler ultrasound, quantitative analysis of ultrasonic elastography tissue diffusion was employed to detect renal parenchyma of each group subjects. 10 elastographic parameter were obtained: average relative strain value(MEAN), standard deviation(SD), area ratio(%AREA), complexity(COMP), kurtosis(KURT), skewness(SKEW),contrast(CONT), entropy(ENT), inverse difference moment(IDM), correlation(CORR),and results of experimental group were compared with those of control group. By Spearman rank correlation test, the correlation of MEAN, CONT, %AREA displayed significant difference respectively with GFR(P<0.05). At the same time, %AREA and MEAN with well correlation in CKD group were compared with the control group, and the ROC curve was plotted, while areas under the curve, critical values, sensitivity values, and specificity values were also calculated.Results: 1. Compared with the normal group, 10 elastic parameters in CKD1 group didn’t significantly changed(P>0.05), but %AREA increased(P<0.05) in group CKD2 and MEAN decreased, %AREA and CONT increased(P<0.05) in group CKD3,meanwhile, decreased MEAN, COMP and SKEW, and increased %AREA,SD and CONT were found in group CKD4 and CKD5(P<0.05); 2. Both %AREA and CONT were negatively correlated with GFR(r=-0.904, P<0.001; r=-0.636, P<0.05), but MEAN was positively correlated with GFR(r=0.802, P<0.001); 3. Compared with the control group,when ROC curve was plotted with %AREA and MEAN of CKD group, the area under the %AREA curve was 0.937 and 14.6 as the critical value, the corresponding sensitivity and specificity were 89.8%, 65.2% respectively, when MEAN curve area was 0.896 and99.2 as the critical value, the corresponding sensitivity and specificity were 86.1% and64.3% respectively.Conclusion: The technology of ultrasonic elastography tissue dispersion quantitative analysis can be used to quantitatively detecte renal parenchymal tissue stiffness in chronic kidney function impairment. Compared with conventional ultrasound, the specificity and sensitivity of MEAN and %AREA are much more better. As higher sensitivity for estimating early chronic kidney function impairment, %AREA is expected to be a sensitive index of early chronic kidney function impairment in CKD.