Acoustic radiation force impulse imaging for noninvasive evaluation of renal parenchyma elasticity: preliminary findings.
Acoustic radiation force impulse imaging for noninvasive evaluation of renal parenchyma elasticity: preliminary findings.
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DOI：
10.1371/journal.pone.0068925
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Liu LN
中科院分区：
文献类型：
--
作者：
Guo LH;Xu HX;Fu HJ;Peng A;Zhang YF;Liu LN
目的探讨声辐射力脉冲（ARFI）检测肾实质弹性的剪切波速度（SWV）对慢性肾脏病（CKD）的诊断价值。327名健康志愿者和64名CKD患者入组研究。在健康志愿者中评价了潜在的影响因素和测量重复性。分析CKD患者SWV与实验室检查的相关性。受试者工作特征曲线（ROC）分析，以评估ARFI的诊断性能。健康志愿者的SWV与年龄显著相关（r =-0.22，P<0.001，n = 327），男性和女性之间存在显著差异（2.06±0.48 m/s vs. 2.2±0.52 m/s，P = 0.018，n = 327）。 然而，它与身高、体重、体重指数、腰围、肾脏尺寸和SWV测量深度（n = 30）无显著相关性。 以组内相关系数表示的观察者间和观察者内一致性分别为0.64（95% CI：0.13至0.82，P = 0.011）和0.6（95% CI：0.31至0.81，P = 0.001）（n = 40）。 健康志愿者的SWV平均值为2.15±0.51 m/s，而CKD患者1、2、3、4和5期的SWV分别为1.81 ± 0.43 m/s、1.79±0.29 m/s、1.81±0.44 m/s、1.64±0.55 m/s和1.36±0.17 m/s。健康志愿者的SWV显著高于CKD患者的各个阶段。ARFI不能预测CKD的不同阶段，除了5期。在CKD患者中，SWV与e-GFR（r = 0.3，P = 0.018）、尿素氮（r =-0.3，P = 0.016）和肌酐（r =-0.41，P = 0.001）相关。 ROC曲线下面积为0.752（95% CI：0.704 ~ 0.797）（P<0.001）。以1.88 m/s为临界值预测CKD的敏感性为71.87%，特异性为69.69%。ARFI可能是检测CKD的潜在有用工具。
To evaluate the diagnostic value of acoustic radiation force impulse (ARFI) to test the elasticity of renal parenchyma by measuring the shear wave velocity (SWV) which might be used to detect chronic kidney disease (CKD). 327 healthy volunteers and 64 CKD patients were enrolled in the study. The potential influencing factors and measurement reproducibility were evaluated in the healthy volunteers. Correlations between SWV and laboratory tests were analyzed in CKD patients.?Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of ARFI. The SWV of healthy volunteers correlated significantly to age (r = −0.22, P<0.001, n = 327) and differed significantly between men and women (2.06±0.48 m/s vs. 2.2±0.52 m/s, P = 0.018, n = 327). However, it did not correlate significantly to height, weight, body mass index, waistline, kidney dimension and the depth for SWV measurement (n = 30). Inter- and intraobserver agreement expressed as intraclass coefficient correlation were 0.64 (95% CI: 0.13 to 0.82, P = 0.011) and 0.6 (95% CI: 0.31 to 0.81, P = 0.001) (n = 40). The mean SWV in healthy volunteers was 2.15±0.51 m/s, while was 1.81±0.43 m/s, 1.79±0.29 m/s, 1.81±0.44 m/s, 1.64±0.55 m/s, and 1.36±0.17 m/s for stage 1, 2, 3, 4 and 5 in CKD patients respectively. The SWV was significantly higher for healthy volunteers compared with each stage in CKD patients. ARFI could not predict the different stages of CKD except stage 5. In CKD patients, SWV correlated to e-GFR (r = 0.3, P = 0.018), to urea nitrogen (r = −0.3, P = 0.016), and to creatinine (r = −0.41, P = 0.001). ROC analyses indicated that the area under the ROC curve was 0.752 (95% CI: 0.704 to 0.797) (P<0.001). The cut-off value for predicting CKD was 1.88 m/s (sensitivity 71.87% and specificity 69.69%). ARFI may be a potentially useful tool in detecting CKD.
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