声辐射力脉冲弹性成像及超微血流成像技术评估IgA肾病严重程度

目的 分析声辐射力脉冲（ARFI）弹性成像及超微血流成像（SMI）评估IgA肾病（IgAN）严重程度的价值。方法 将124例经穿刺右肾中下极活检病理证实的IgAN患者根据估测肾小球滤过率（eGFR）分为A、B、C组。A组32例，eGFR>90 ml/（min·1.73 m²）；B组54例，eGFR 60~90 ml/（min·1.73 m²）；C组38例，eGFR<60 ml/（min·1.73 m²），于肾活检前3天内行ARFI及SMI。将取样框置于右肾中下极、两肾柱间邻近肾被膜皮质区域，分别检测剪切波速度（SWV）及血流阻力指数（RI）。对比3组SWV、RI，以Pearson相关分析法观察SWV与RI的相关性。结果 A、B、C组SWV逐渐降低，RI逐渐增加，组间两两比较差异均有统计学意义（P均<0.05）。相关性分析结果显示，A、B、C组SWV均与RI呈负相关（r=-0.709、P<0.001，r=-0.792、P<0.001，r=-0.473、P=0.003）。结论 利用ARFI及SMI能无创评估IgAN严重程度。

Acoustic radiation force impulse elastography and superb microvasular imaging for evaluation of the severity of IgA nephropathy

Objective To observe the value of acoustic radiation force impulse (ARFI) elastography and superb microvasular imaging (SMI) for assessing the severity of IgA nephropathy (IgAN). Methods Totally 124 patients with IgAN confirmed through biopsy of renal (puncture of the middle and lower pole of the right kidney) were divided into groups A, B and C groups according to the value of estimated glomerular filtration rate (eGFR). There were 32 cases with eGFR >90 ml/(min·1.73 m²) in group A, 54 cases with eGFR 60-90 ml/(min·1.73 m²) in group B and 38 cases with eGFR <60 ml/(min·1.73 m²) in group C. All patients completed ARFI and SMI within 3 days before renal biopsy. The sampling frames were placed in the middle and lower poles of the right kidney, and the cortical area near the renal capsule between two renal columns. Shear wave velocity (SWV) and vascular resistance index (RI) were measured, respectively. SWV and RI were compared among 3 groups, and the correlations of RI and SWV were explored with Pearson correlation analysis method. Results In group A, B and C, SWV gradually decreased and RI gradually increased, and there were statistically differences between each 2 groups (all P<0.05). Correlation analysis results showed that SWI in groups A, B and C were negatively correlated with RI (r=-0.709, P<0.001; r=-0.792, P<0.001; r=-0.473, P=0.003). Conclusion ARFI and SMI could noninvasively assess the severity of IgAN.