Application of shear wave elastography in the study of renal tissue elasticity in patients with diabetic nephropathy / 中华超声影像学杂志

ABSTRACT

Objective To investigate the clinical value of real-time shear wave elastography( SWE) in early diagnosis of diabetic nephropathy ( DN ) . Methods One hundred and fifty-five patients with type 2 diabetes mellitus (DM) in our hospital were selected as DN group and 54 healthy volunteers with matched age-sex were selected as control group . According to the criteria of Mogensen staging ,patients of DN group were divided into 3 subgroups according to urine protein/creatinine ( ACR)group A ( DM or DN Ⅰ ,Ⅱ ) , ACR＜30 mg/g ;group B ( DN Ⅲ ) ,ACR 30 －300 mg/g ;group C ( DN Ⅳ ,Ⅴ ) ,ACR＞ 300 mg/g . All subjects were examined by SWE technique to detect the maximum ,mean and minimum Young′s modulus values ( Emax ,Emean ,Emin) of the middle of left renal parenchyma ,the values of Young′s modulus in the control group and DN patients were compared . The relationship between Young′s modulus and ACR in patients with DN was analyzed . Results The Emax ,Emean and Emin in DN patients were all greater than those in control group ( P ＜0 .05) . In group A ,B and C ,Emax ,Emean and Emin gradually increased ( P＜0 .05) . Spearman correlation analysis showed that there was a positive correlation between Young′s modulus and ACR in patients with DN ( r ＝ 0 .817 ,0 .764 ,0 .609 ;all P＝ 0 .000) . ROC curve analysis showed that the area under the curve of Emax diagnosis DN Ⅲ stage was 0 .810 ,the cut-point value was 6 .65 kPa ,the sensitivity was 79 .0% ,and the specificity was 81 .7% ;the area under the curve of Emean diagnosis DN Ⅲ stage was 0 .785 ,and the cut-off value was 3 .69 kPa ,sensitivity 62 .8% ,specificity 78 .3% . Conclusions SWE technique can quantitatively analyze renal parenchyma hardness in patients with different stages of DN ,which may provide new diagnostic information for early diagnosis of DN .