Acoustic radiation force impulse imaging for non-invasive assessment of renal histopathology in chronic kidney disease.
Acoustic radiation force impulse imaging for non-invasive assessment of renal histopathology in chronic kidney disease.
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声辐射力脉冲成像对慢性肾脏病肾组织病理学的无创评估。
DOI：
10.1371/journal.pone.0115051
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Qin GC
中科院分区：
文献类型：
--
作者：
Hu Q;Wang XY;He HG;Wei HM;Kang LK;Qin GC
探讨声辐射力脉冲（ARFI）定量测定硬度值在评价慢性肾脏病（CKD）肾组织纤维化中的作用。在2013年6月至2014年4月期间入组了163例CKD患者和32例健康志愿者。ARFI定量，给出剪切波速度（SWV），进行测量肾实质硬度。将ARFI成像和常规超声（US）的诊断性能与肾活检的组织学评分进行比较。分析SWV测量的观察者内和观察者间可靠性。在CKD患者中，SWV测量值与病理参数（r =-0.422--0.511，P<0.001）、血清肌酐（r =-0.503，P<0.001）和肾小球滤过率（r = 0.587，P<0.001）显著相关。 重度损伤（组织学评分：≥19分）肾脏的平均SWV显著低于轻度损伤（组织学评分：≤9分）、中度损伤（组织学评分：10-18分）和对照组（均P<0.001）。受试者工作特征（ROC）曲线分析表明，使用ARFI成像诊断肾组织纤维化的ROC曲线下面积上级这些传统的US参数。以2.65 m/s诊断轻度肾功能损害、2.50 m/s诊断中度肾功能损害和2.33 m/s诊断重度肾功能损害的最佳截断值，相应的ROC曲线下面积分别为0.735、0.744和0.895。SWV测量的观察者内和观察者间一致性分别为0.709（95%CI：0.390-0.859，P<0.001）和0.627（95%CI：0.233-0.818，P = 0.004）。 ARFI可能是评价CKD患者肾组织纤维化的有效工具。
To investigate the stiffness values obtained by acoustic radiation force impulse (ARFI) quantification in assessing renal histological fibrosis of chronic kidney disease (CKD). 163 patients with CKD and 32 healthy volunteers were enrolled between June 2013 and April 2014. ARFI quantification, given as shear wave velocity (SWV), was performed to measure renal parenchyma stiffness. Diagnostic performance of ARFI imaging and conventional ultrasound (US) were compared with histologic scores at renal biopsy. Intra- and inter-observer reliability of SWV measurement was analyzed. In CKD patients, SWV measurements correlated significantly with pathological parameters (r = −0.422–−0.511, P<0.001), serum creatinine (r = −0.503, P<0.001), and glomerular filtration rate (r = 0.587, P<0.001). The mean SWV in kidneys with severely impaired (histologic score: ≥19 points) was significant lower than that mildly impaired (histologic score: ≤9 points), moderately impaired (histologic score: 10–18 points), and control groups (all P<0.001). Receiver operating characteristic (ROC) curves analyses indicated that the area under the ROC curve for the diagnosis of renal histological fibrosis using ARFI imaging was superior to these conventional US parameters. Using the optimal cut-off value of 2.65 m/s for the diagnosis of mildly impaired kidneys, 2.50 m/s for moderately impaired kidneys, and 2.33 m/s for severely impaired kidneys, the corresponding area under the ROC curves were 0.735, 0.744, and 0.895, respectively. Intra- and intre-observer agreement of SWV measurements were 0.709 (95% CI: 0.390–0.859, P<0.001) and 0.627 (95% CI: 0.233–0.818, P = 0.004), respectively. ARFI may be an effective tool for evaluating renal histological fibrosis in CKD patients.
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影响因子：
4.3
作者：
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