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, conventionallength(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 parameterschronic 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.