The Study Of ARFI Quantification Technique In The Application Of Chronic Kidney Disease

Objective:To evaluate the renal parenchymal elasticity with ARFI quantification technique in 54 patients with chronic kidney disease of different stages,and to compare with the results of conventional ultrasound and renal functional test and staging of chronic kidney disease,in order to further discuss the clinical value of ARFI quantification technique in the application of the diagnosis and staging of chronic kidney disease,and to provide a more useful information for the application of ARFI quantification technique in chronic kidney disease.Methods:54 patients with chronic kidney disease who have underwent ultrasound-guided renal biopsy and 30 healthy volunteers who were enrolled between May 2017 and December 2017 in the Second Affiliated Hospital of KunMing Medical University.All patients have the indication of renal biopsy and they agree to do this.CKD was defined as either kidney damage or Glomerular Filtration Rate(GFR)was below 60 ml/(min· 1.73 m2)for at least 3 months.All the subjects were examined by both conventional ultrasound and the ARFI quantification technique.The results of ultrasound and renal functional test of the kidney were compared analyzed.Results:The mean value of SWV measurements in the 30 healthy adults was 3.18±0.26,and in kidneys from CKD1 stage(13 cases)?CKD2 stage(9 cases)?CKD3 stage(15 cases)?CKD4 stage(lOcases)?CKD5 stage(7cases)were 2.79±0.14?2.60±0.15.2.57±0.15.2.50±0.13.2.14±0.20,respectively.The area under the ROC curves by VTQ,interlobar arterial RI,renal length and parenchymal thickness,were 0.974?0,748?0.689 and 0.835,respectively,for the diagnosis of CKD.The difference of SWV value between different stages of CKD is statistically significant(F=48.623,P<0.001),and the difference of SWV value between healthy group and all CKD group is statistically significant(P<0.001);and the difference of SWV value between CKD1 stage and CKD2 stage?CKD3 stage?CKD4 stage?CKD5 stage is statistically significant(P<0.05),and the difference of SWV value between CKD5 stage and another 4 stages is statistically significant(P<0.05).There was no statistical difference observed between CKD2 stage and CKD3 stage,CKD3 stage and CKD4 stage,CKD2 stage and CKD4 stage(P>0.05).Conclusion:1.The mean SWV values in healthy adults is significantly higher than that of all stages of CKD group,the VTQ technique is valuable in diagnosing the chronic kidney disease.2.The VTQ technique is helpful in diagnosing early stages of chronic kidney disease and guiding clinical staging of CKD.3.The clinical value of VTQ technique in the diagnosis of CKD is higher than that of interlobar arterial RI and renal size.4.The SWV values and serum creatinine,blood urea nitrogen of patients with chronic kidney disease were negatively correlated.We can judge the renal function of patients with chronic kidney disease according to the SWV value.