声触诊组织定量技术在IgA肾病的应用

  目的  评价声触诊组织定量(virtual touch tissue quantification, VTQ)技术在IgA肾病(IgA nephropathy, IgAN)的应用价值。  方法  选择2012年1月1日至4月30日北京协和医院经肾活检证实的28例IgAN患者, 对所有患者左肾进行常规超声(肾脏长径、皮质厚度、叶间动脉阻力指数)及VTQ超声[剪切波速度(shear wave velocity, SWV)]检查。分析常规超声与VTQ指标间, 以及各超声指标与患者临床/病理指标-慢性肾脏病(chronic kidney disease, CKD)分期、Lee分级、肾小球硬化指数(glomerular sclerosis index, GSI)、肾小管萎缩(tubular atrophy, TA)以及肾间质纤维化(interstitial fibrosis, IF)的相关性。  结果  IgAN患者肾脏常规超声指标与其VTQ结果、临床/病理指标无显著相关性(P > 0.05);VTQ测定的SWV与CKD分期(r=-0.382, P=0.045)、Lee分级(r=-0.407, P=0.031)及IF(r=-0.397, P=0.036)呈负相关, 与GSI和TA无显著相关性(P > 0.05)。  结论  通过VTQ技术测定的肾皮质SWV与多项临床/病理指标存在相关性, 这一新型超声弹性成像技术的临床意义值得进一步研究。

Application of Virtual Touch Tissue Quantification Technique in IgA Nephropathy

  Objective  To evaluate the application of virtual touch tissue quantification (VTQ) technique in immunoglobulin A nephropathy (IgAN).  Methods  A total of 28 patients were included in present study who underwent kidney biopsy in Peking Union Medical College Hospital from January 1, 2012 to April 30, 2012. On sonography, conventional[length(L), thickness (T), resistive index(RI)], and VTQ (shear wave velocity, SWV) parameters of left kidney were measured. Then using Spearman correlation analysis, the correlations between SWV and clinicopathologic parameters[chronic kidney disease(CKD) stage, Lee grade, glomerular sclerosis index (GSI), tubular atrophy(TA), interstitial fibrosis(IF)] and the association of SWV and conventional ultrasound measurements were evaluated.  Results  No significant correlation was found between conventional ultrasound measurements and SWV, as well as clinicopathologic parameters (all P > 0.05). However, Spearman analysis indicated that SWV showed significant correlations with CKD stage (r=-0.382, P=0.045), Lee grade (r=-0.407, P=0.031), and IF (r=-0.397, P=0.036).  Conclusions  As a novel sono-elastography technique, VTQ correlates with multiple clinicopathologic parameters by measuring renal cortical stiffness. Therefore it is of great value in clinical application and warrants further investigation.