Three Dimensional Ultrasound Combined With Elastography In The Diagnosis Of Chronic Renal Disease

Objective: The chronic kidney disease patients after abdominal three-dimensional ultrasound observation of different renal volume change stages,to explore the application value of three-dimensional ultrasound in chronic kidney disease patients with chronic kidney disease;abdominal two-dimensional ultrasound application of shear wave elastography was observed in different stages of the shear wave velocity,to explore the application value of shear wave elastography in chronic kidney disease;to further explore the three-dimensional ultrasound shear wave elastography,kidney volume and renal artery resistance index in different stages of chronic kidney disease correlation,and the application value in diagnosis of chronic kidney disease,in order to provide reference for clinical ultrasound imaging in early diagnosis of chronic kidney disease.Methods: 125 cases in our hospital were clinical or renal biopsy diagnosed with chronic kidney disease(chronic kidney disease,CKD)patients,including 55 cases of male patients,70 female patients,aged 19-79 years old,mean age 45.6 ±13.6 years old,BMI 18.5~23.9kg/m2,CKD met the diagnostic criteria the internationally recognized K/DOQI,staging methods according to K/DOQI CKD clinical stage.For all of the selected objects,underwent conventional two-dimensional ultrasound on renal multi-directional continuous scanning,carefully observe the size and shape of the kidney capsule,whether smooth,internal echo and medullary thickness,and measure resistance index(Resistive Index,RI)of renal artery in the resting state,after accurate positioning,at the same time,record them.After that,start the 3D model of 3D scanning to obtain three-dimensional images of the kidney.Next,by pointing down the boundary of kidney,the software automatically calculates the kidney volume in ml to record.Then all the selected kidneys were subjected to two-dimensional ultrasound longitudinal renal scans.After the image was stable,the elastic imaging mode was started at resting state,and the shear wave velocity of the renal cortex was measured by the meter per second(m/s).Result:1.In patients with chronic kidney disease,with the increase of CKD stage,the shear wave velocity of renal cortex showed a decreasing trend,which was negatively correlated with the stage of CKD,and the difference was statistically significant(P <0.05).2.In the patients with chronic kidney disease,with the increase of CKD stage,the volume showed a decreasing trend,which was negatively correlated with the stage of CKD,and the difference was statistically significant(P < 0.05).3.In the patients with chronic kidney disease,the resistance index of renal artery increased with the increase of CKD stage,which was positively correlated with the stage of CKD,and the difference was statistically significant(P < 0.05).4.In patients with chronic kidney disease,with the increase of CKD stage,there was a certain correlation between the resistance index of renal cortex,the shear wave velocity of renal volume,renal artery,the smaller the RI,the greater the volume between RI and volume with the staging of chronic kidney disease increases,negative correlation,P <0.05,statistically meaning;elastic value is small,the bigger the RI,the elasticity and RI along with the increase of CKD staging,negative correlation,P < 0.05,with statistical significance;the elastic value is greater,the greater the volume between elasticity and volume with the staging of chronic kidney disease increased,showed a positive correlation,P< 0.05,with statistical significance.5.In the diagnosis of chronic kidney disease,the area of the shear wave elastic imaging under the ROC curve is greater than that of the RI and the volume.Conclusion:1.By abdominal ultrasound shear wave elastography technology can be used for shear wave velocity.The observation of chronic kidney disease in renal cortex has the advantages of simple operation,good repeatability.It can provide a new imaging basis for patients with chronic kidney disease.Abdominal three-dimensional ultrasound technology can be more intuitive observation of chronic kidney disease in patients with renal morphology,structure,size,and good reproducibility,can provide patients with more intuitive imaging methods,while providing a new non-invasive examination method for patients with chronic kidney disease.2.With chronic kidney disease stage increased,the three-dimensional volume showed a decreasing trend,RI showed a increasing trend,and the shear wave velocity showed a decreasing trend.There is a certain correlation between them and the three,that is,with the volume decline,RI increasing,the shear wave velocity decrease with the increase of RI the volume,and the shear wave velocity showed a decreasing trend,with the decrease of the shear wave velocity increasing,the volume of RI showed a decreasing trend.3.In the diagnosis of chronic renal disease,shear wave elastography is superior to the three-dimensional volume and renal arterial resistance index.