声触诊组织定量技术测量肾脏弹性的初步研究

目的 评估声触诊组织定量技术(VTQ)测量肾脏弹性的可重复性以及影响因素,同时研究病理状态下肾脏弹性的变化.方法 选取年轻健康志愿者65名、肾功能正常老年志愿者10名、终末期肾病老年患者10例.采用VTQ技术测量受试者肾脏剪切波速度(SWV),记录取样深度.研究操作者间和操作者内VTQ测量的可重复性.比较不同年龄、性别、身高、体重、体重指数、腰围、右肾长径、右肾短径、右肾中部被膜距探头距离、取样深度的年轻健康志愿者右肾实质SWV的差异,分析年轻健康志愿者年龄、身高、体重、体重指数、腰围、右肾长径、右肾短径、右肾中部被膜距探头距离、取样深度与右肾实质SWV的相关性.比较肾功能正常老年志愿者与终末期肾病老年患者右肾实质SWV的差异.结果 操作者间及同一名操作者前后测量右肾实质SWV差异无统计学意义.不同年龄、性别、身高、体重、体重指数、腰围、右肾长径、右肾短径、右肾中部被膜距探头距离、取样深度的年轻健康志愿者右肾实质SWV的差异无统计学意义(t值分别为-0.623、0.249、-0.448、-0.757、-0.253、-0.242、-0.762、-1.056、-1.422、-0.291,P值均>0.05).右肾实质SWV与年轻健康志愿者年龄、身高、体重、体重指数、腰围、右肾长径、右肾短径、右肾中部被膜距探头距离、取样深度均无相关性(r值分别为-0.12、-0.02、-0.04、0.04、-0.04、-0.24、-0.24、-0.27、-0.18,P值均>0.05).年轻健康志愿者右肾实质中部、肾窦SWV分别为(2.41±0.52) m/s和(1.73±0.44) m/s,差异有统计学意义(t=5.903,P=0.000);左、右肾实质中部SWV差异无统计学意义.肾功能正常老年志愿者、终末期肾病老年患者右肾实质中部SWV分别为(2.03±0.37) m/s和(1.38±0.24) m/s,差异有统计学意义(t=-4.651,P=0.000).结论 VTQ测量肾脏实质SWV重复性好,变异小,且测量出终末期肾病老年患者右肾实质SWV较肾功能正常老年人显著降低.VTQ是测量肾脏弹性可靠的方法.

Virtual touch tissue quantification imaging of kidney:a preliminary research

Objective To evaluate the reproducibility of virtual touch tissue quantification(VTQ)imaging performed on kidney.Methods Eighty-five volunteers were included in this study,including sixty-five young healthy volunteers,ten aged control volunteers and ten aged patients with end-stage renal disease(ESRD).VTQ which is an implementation of ultrasound acoustic radiation force impulse(ARFI) imaging was performed on kidney,measurements of shear wave velocity(SWV)and the depth for SWV recorded.Interobserver and intraobserver evaluations were performed.The mean SWV measurement was compared in different groups such as age,sex,waistline,height,weight,body mass index(BMI),kidney dimension,the mean depth of the middle third of the right renal capsule from the probe and the depth for SWV measurements.Correlations between mean SWV measurement and variables such as age,sex,waistline,height,weight,BMI,kidney dimension,the mean depth of the middle third of the right renal capsule from the probe and the depth for SWV measurements were analyzed.The differences of SWV measurements between ten aged control volunteers and ten aged patients with ESRD were investigated.Results The VTQ imaging performed on kidney had significant intraobserver and interobserver reproducibility.The mean SWV measurementof the renal parenchyma was not significantly different according to age,sex,waistline,height,weight,BMI,kidney dimension,the mean depth of the middle third of the right renal capsule from the probe and the depth for SWV measurements(t=-0.623,0.249,-0.448,-0.757,-0.253,-0.242,-0.762,-1.056,-1.422,-0.291,all P>0.05).The mean SWV measurement of the renal parenchyma did not correlate highly significant with age,waistline,height,weight,BMI,kidney dimension,the mean depth of the middle third of the right renal capsule from the probe and the depth for SWV measurements(r=-0.12,-0.02,-0.04,0.04,-0.04,-0.24,-0.24,-0.27,-0.18,all P>0.05).The mean SWV differences between the middle pole of right renal parenchyma and renal sinus were statistically significant(2.41±0.52) m/s vs(1.73±0.44) m/s,t=5.903,P=0.000].Mean SWV measurements differences between the middle pole of right and left renal parenchyma were statistically not significant.The mean SWV differences between patients with ESRD and controls were statistically significant(2.03±0.37) m/s vs(1.38±0.24)m/s,t=-4.651,P=0.000].Conclusions VTQ imaging performed on kidneys were reproducible and it was not significantly influenced by age,sex,waistline,height,weight,etc.The mean SWV measurements in patients with ESRD were slower than that in controls.This study indicated that VTQ was a reliable method to detect renal elasticity.