The Application Value Of Shear Wave Elastic Imaging In Chronic Kidney Disease

Objective170 patients with chronic kidney disease(including CKD group and proteinuria group)and 50 healthy volunteers were selected for two-dimensional ultrasound and shear wave elastography.To evaluate the value of shear wave elastography in the diagnosis of chronic kidney disease.Methods1.Chronic kidney disease with high creatinine: 50 healthy volunteers and 100 CKD patients with elevated creatinine were examined respectively.The patients in the CKD group were divided into 5 stages according to GFR,including CKD1,CKD2,CKD3,CKD4 and CKD5;The kidney diameter,parenchyma thickness and Young's modulus(including Emean,Emax and Emin)were measured in each group,and the differences between the normal group and the CKD group were compared.The differences of parameters between different stages of CKD group were analyzed and compared.The parameters of CKD group were compared with those of different stages.Correlation analysis was carried out and ROC curve was drawn to calculate the cutoff value of Young's modulus between normal group and CKD group.2.Chronic kidney disease with elevated proteinuria: 50 healthy volunteers and 70 patients with elevated proteinuria were examined.The proteinuria group was divided into two groups according to the amount of 24 hours urine protein,that is,24 urine protein ? 3.5 g and 24 urine protein < 3.5 g;The renal length diameter,parenchyma thickness,renal Young's modulus(including Emean,Emax and Emin)were measuredin each group,and the differences between normal group and proteinuria group were compared with those of normal group and albuminuria group,and whether there was any difference between normal group and albuminuria group.The differences of parameters between 24-urine protein ? 3.5 g and 24-urine protein < 3.5 g were analyzed and compared.The age,sex,height,weight,creatinine value and 24-hour urine protein were recorded.Results1.Comparison between CKD group and normal groupThe thickness of parenchyma and the length of kidney in normal group were larger than those in CKD group,while the mean values of Emean,Emax and Emin were lower than those in CKD group.There was a significant difference in the parameters between the two groups(P < 0.05).There was a significant difference in the parameters between different stages in the CKD group(P < 0.05).There was a significant difference in the mean value between the two groups except Emin in CKD1,CKD2 stage and CKD2,CKD3 stage of Emax(P < 0.05).There was a significant negative correlation between renal length(r = 0.667,P < 0.05),parenchyma thickness(r = 0.677,P < 0.05)and CKD stage(Emean(r = 0.969,P <0.05),Emax(r = 0.869,P < 0.05),Emin(r = 0.830,P < 0.05)was positively correlated with CKD staging.The results of ROC curve showed that the sensitivity was 85.36%,72.87%,80.32%,and the specificity was 90.47%,96.11%,86.28%,respectively,when Emean=2.86 kPa,Emax=6.24 kPa,Emin=1.69 kPa was used as the critical value for the diagnosis of normal group and CKD group.2.Comparison between albuminuria group and normal groupThere was no significant difference in renal diameter and parenchyma thickness between normal group and proteinuria group(P > 0.05),but Emean,Emax and Emin in proteinuria group were significantly higher than those in normal group(P < 0.05).24 h urinary protein ? 3.5g and < 3.5g had significant difference in renal length diameter,Emean and Emax(P < 0.05),but there was no significant difference in parenchyma thickness and Emin(P > 0.05).Renal long diameter,parenchyma thickness,Emean,Emax between albuminuria group and CKD group And the difference of Emin was statistically significant(P < 0.05).ConclusionShear wave elastic imaging can be used as a non-invasive technique to quantitatively evaluate chronic kidney disease,observe the progress of chronic renal disease disease in real time,and improve the early diagnosis of CKD.