协和医学杂志

2013, (03)

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声触诊组织定量技术在慢性肾病中应用的影响因素:肾-脾对比研究
Factors affecting the application of virtual touch tissue quantification technique in chronic kidney disease: a spleen-kidney comparative study

陈丽萌;戴晴;姜玉新;吕珂;王亮;夏鹏

摘要(Abstract):

目的 本研究以脾脏作为对照,分析声触诊组织定量技术在慢性肾病中应用的影响因素。方法 选取2011年9月1日至2012年4月30日在北京协和医院行肾活检的慢性肾病患者62名。在相同体位下,使用声触诊组织定量技术测量患者的左肾皮质及同一深度脾脏实质的组织弹性。计算每名患者肾脏弹性测值的变异系数,并与脾脏测值对比,分析测量次数、测量深度、CKD病理诊断及临床分期对肾脏弹性测值变异度水平的影响。结果 (1)测量次数的增加不能减低肾脏及脾脏的测值变异性,但是可以增加测量均值的稳定性。(2)肾脏测值变异性与测量深度呈正相关,而脾脏测值变异性与测量深度无显著相关性。(3)慢性肾病分期及病理诊断与肾脏测值变异性无显著相关性。结论 采用声触诊组织定量技术测量肾组织弹性时需要在方法学上进行更为细致而统一的规范。根据本研究建议测量次数宜在5-10之间,测量深度宜适当降低,测量部位宜选择肾中极且使入射声束与肾锥体长轴相平行。
Objective With spleen as control, to study the methodological factors that influence the application of virtual touch tissue quantification (VTQ) technique in chronic kidney disease (CKD). Methods A total of sixty-two patients were included in this study who underwent kidney biopsy in PUMC hospital between September 2011 and April 2012. Under the same conditions, the tissue shear wave velocity (SWV) of left kidney cortex and spleen parenchyma were measured with VTQ technique. Coefficient of variation (CV) was calculated to identify the variability of measurements. With regard to repetition number, measuring depth, pathologic etiology, and CKD stage, their impacts on CV were analyzed and compared between kidney and spleen. Results (1) Repetition number: CV level did not reduce when the number of measurements was increasing. But the stability of mean value of SWV could be improved. (2) Measuring depth: kidney CV had a significant positive correlation with the depth of measurement, while the tendency was not observed in spleen. (3) CKD stage and pathologic etiology: Spearman analysis indicated that neither CKD stage nor pathologic etiology showed a significant correlation with kidney CV level. Conclusions Due to the special internal architecture of kidney, applying VTQ technique in renal disease need a number of detailed and unified measurement specifications. From present study, we suggest following measuring requirements: repeating measurements 5-10 times, reducing the depth appropriately, sampling the middle part of kidney, ensuring incident beam parallel to the axis of renal pyramid.

关键词(KeyWords): |声触诊组织定量技术|慢性肾病|弹性成像|变异系数|
|Virtual touch tissue quantification| Chronic kidney disease| Elastography| Coefficient of variatio|

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作者(Author): 陈丽萌;戴晴;姜玉新;吕珂;王亮;夏鹏

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