三维超声血管指数及肾脏体积在慢性肾脏疾病诊断中的价值

目的 探讨三维超声参数--血管指数(VI)及肾脏体积对慢性肾脏疾病(CKD)的诊断价值. 方法 病例组80例和对照组30名,应用三维超声技术计算VI及肾脏体积,二维超声技术计算叶间动脉阻力指数(RI)、皮质厚度(CT)及肾脏体积,并进行统计学分析.结果 与对照组相比VI在CKD 2期开始减小,RI在CKD 3期开始升高,CT在CKD 3期开始降低,VI在CKD早期及晚期诊断的敏感度、特异度及诊断价值均高于RI,差异有统计学意义;与对照组相比CKD 1期肾脏三维及二维体积增大,三维肾脏体积在CKD 2期后缩小,二维肾脏体积在CKD 4期后缩小,差异有统计学意义;VI、三维肾脏体积、CT、二维肾脏体积与病理学积分呈负相关 (r=-0.67、-0.52、-0.43、-0.52).结论 VI、三维肾脏体积较RI、CT、二维肾脏体积能早期敏感地发现CKD肾功能异常.

Diagnostic value of vascularity index and renal volume with three-dimensional ultrasound in chronic kidney disease

Objective To explore the diagnostic value of three-dimensional ultrasound parameters-vascularity index (VI) and the volume of kidney in chronic kidney disease (CKD). Methods A total of 80 CKD patients at different stages and 30 healthy adults were enrolled in the study. VI and the renal volume were calculated with three-dimensional ultrasound, while resistance index (RI), cortical thickness (CT) and the volume of kidney were calculated with two-dimensional ultrasound, and the correlation of those parameters were analyzed statistically. Results VI of CKD2 patients reduced significantly compared with the control group, and RI of CKD3 patients increased significantly, CT of CKD3 patients reduced significantly. The diagnostic sensitivity, specificity and diagnostic value of VI in patients with early and late CKD were all higher than thpse of RI. Compared with the control group, three-dimensional ultrasound of renal volume and two-dimensional ultrasound volume of CKD 1 patients increased significantly, three-dimensional ultrasound volume of CKD2 patients reduced significantly, and two-dimensional ultrasound volume of CKD4 patients reduced significantly. There was significant negative correlation among VI, three-dimensional ultrasound volume, CT, two-dimensional ultrasound volume and pathological change scoring (r=-0.67, -0.52, -0.43, -0.52). Conclusion VI and three-dimensional ultrasound volume can detect renal function damage more earlier and sensitively than RI and two-dimensional ultrasound volume.