Prediction of renal allograft chronic rejection using a model based on contrast-enhanced ultrasonography
Prediction of renal allograft chronic rejection using a model based on contrast-enhanced ultrasonography
复制标题
使用基于超声造影的模型预测肾同种异体移植慢性排斥反应
DOI：
10.1111/micc.12544
复制
发表时间：
2019-08-01
期刊：
影响因子：
2.4
通讯作者：
He, Wanyuan
中科院分区：
文献类型：
--
作者：
Yang, Cheng;Wu, Shengdi;He, Wanyuan
目的探讨超声造影(CEUS)在移植肾慢性排斥反应(CR)诊断中的价值。方法104例疑似AR或CR的患者入选本研究，其中派生组66例，验证组38例。在活检前，所有患者都接受了超声检查。结果CR组延髓上升时间(RT)和达峰时间(TTP)明显长于AR组。CR组肾脏体积明显减小，AR组肾脏体积明显增大。在衍生组中，多变量分析确定年龄、肾体积变化和TTPM是独立的预测因素。基于多因素分析结果和各指标的受试者工作特征下面积曲线，我们构建了一个新的指标：P=-5.424+0.074 x年龄-9.818 x肾体积变化+0.115 x TPM，新指标=e(P)/(1+e(P))。新的指标区分了CR和AR，具有比任何其他参数更好的AUROCs。结论新指标为CR提供了一种新的诊断模式。
Objective To evaluate the application of contrast-enhanced ultrasonography (CEUS) for the diagnosis of renal allograft chronic rejection (CR). Methods A total of 104 patients who were suspected to have AR or CR were enrolled in this study (derivation group, n = 66; validation group, n = 38). Before biopsy, all patients received an ultrasound examination. Results In the CR group, rising time (RT) and time to peak (TTP) of medulla (RTm and TTPm, respectively) were significantly longer compared to those in the AR group. The kidney volume was significantly decreased in the CR group but was increased in the AR group. In the derivation group, age, change in kidney volume, and TTPm were identified as independent predictors by multivariate analysis. Based on the multivariate analysis results and area under receiver operating characteristic (ROC) curves (AUROCs) of individual markers, we constructed a new index as follows: P = -5.424 + 0.074 x age -9.818 x kidney volume change + 0.115 x TTPm; New Index = e(P)/(1 + e(P)). The new index discriminates CR from AR and had better AUROCs than any other parameters. Conclusion In conclusion, the new index provides a new diagnosis model for CR.