Application Of Shear Wave Elastography In Noninvasive Diagnosis Of 1-3 Stage Chronic Renal Disease

Objective:Compared with traditional B-ultrasound and Color doppler flow imaging,to discuss the value of shear wave elastography imaging in non-invasive diagnosis of1-3 stage chronic kidney disease.Methods:1.111 patients with chronic kidney disease(CKD)were selected as experimental group and divided into CKD1-3 stage group according to glomerular filtration rate and 60 healthy persons as control group.2.B-US was used to observe the double kidney size,morphologic structure and echo of renal parenchyma.CDFI was used to observe the coronary injection of intrarenal blood flow,measure the peak systolic velocity and resistance index of the main renal artery,the segmental renal artery and the interlobar renal artery.The elastic value of the middle and lower pole parenchyma of right kidney was measured on the long axis section of the right kidney,expressed Young's modulus(YM)in kPa.3.All patients with CKD underwent renal biopsy under the guidance of ultrasound in the inferior pole of the right kidney,and renal biopsy tissues were examined by light microscopy and immunofluorescence.Results:1.B-US The parenchyma echo was enhanced in 13 patients in CKD3 stage group,and there was no significant difference in cortical thickness and renal size between CKD1-3 groups and control group.2.CDFI CKD3 stage group was compared with control group,the Vs and RI of MRA,the Vs of IRA all have significant differences.There was no significant different in Vs and RI between CKD1-2 groups and control group.3.SWE Compared with the control group,the YM value of the middle andlower pole parenchyma of the CKD1-3 stage groups was significantly different from that of the control group(P < 0.05).With 5.45 kPa as the best diagnostic threshold for the diagnosis of CKD 1-3 stages,the sensitivity is 78.1%,the specificity is 81.6% and the area under the curve is 0.877.The YM value of renal parenchyma was positively correlated with SCr(r=0.576,P<0.01)and BUN(r=0.352,P<0.01),and negatively correlated with GFR(r=?0.646,P<0.01).4.Compared with the control group,the renal parenchyma elasticity of the patients with membranous nephropathy stage II was significantly different from that of the control group.Conclusion:1.B-US and CDFI can provide some clinical reference information for the diagnosis and monitoring of CKD.2.SWE imaging can quantify the hardness of renal tissue and reflect the degree of renal parenchyma fibrosis by elastic value,which directly reflects the pathological characteristics of the tissue.SWE can provide extral diagnostic information when there're no obvious abnormal changes in the B-US and the CDFI,and provides a valuable reference for the early diagnosis of CKD.3.The YM value of renal parenchyma had a good correlation with GFR and SCr,which indicated that the elastic value of renal parenchyma could reflect the degree of renal injury.