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| Clinical value of real-time shear wave elastography in evaluating renal function in patients with diabetic kidney disease |
| Qiu Siying1，Jiang Zewen2，Wu Chiqiu1，Chen Duoduo1 |
1.Department of Special Clinical Lab,Zhejiang General Tearn Hospital of Chinese People's Armed Police Force,Hangzhou 310051,China;
2.Department of Outpatient,Zhejiang General Team Hospi-tal of Chinese People's Armed Police Force,Hangzhou 310051,China |
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Abstract Objective To investigate the clinical value of ultrasound real-time shear wave elastography (SWE) in evaluating renal function in patients with diabetic kidney disease (DKD), and thus to provide evidence for elary diagnosis and clinical treatment of DKD. Methods Sixty-two patients with DKD and 14 cases with normal renal function were collected from June 2016 to May 2019.There were 21,24 and 17 cases in the early nephropathy,clinical nephropathy and uremia groups among the DKD patients,respectively.All subjects received conventional ultrasound,SWE and99mTc-DTPA renal dynamic imaging examination. The differences of conventional ultrasound parameters,mean Young′s modulus Emean) and glomerular filtration rate (GFR) were analyzed. The nonlinear relationship between GFR and Emean was fitted according to the scatter diagram, and the quation was established.Results There was no significant difference in conventional ultrasound parameters (length, physical evidence, volume) between steps groups (P >0.05). SWE parameters-Emean was gradually increased in left kidney, right kidney and both kidneys from the early nephropathy group (lowest) to the uremia group (highest), and the difference was statisticalally significant compared with the control group (P <0.05). Among the subgroups of DKD,the uremia group was the highest,and the early nephropathy group was the lowest, and the difference between each DKD subgroup was statistically significant (P <0.05). The level of total GFR in each DKD subgroup decreased, and the difference was statistically significant, compared with that in the control group (P <0.01). As the total GFR level of radiolabels decreases,the average Emean value gradually increases. Growth curve fitting was made to establish the equation E (Y)=exp (5.789-0.417X)(P <0.001), and the fitting effect was good (R2=0.918). The sensitivity ands pecificity were 77.4% and 83.1% while Emean threshold was 3.53 kPa in the early stage group,sensitivity and specificity were 80.8% and 90.2 while Emean threshold was 4.49 kPa in the clinical nephropathy group,and sensitivity and specificity were 83.5% and 92.6% while Emean threshold was 5.47 kPa in the uremia group,respectively.Conclusion SWE possesses high diagnostic efficiency in the diagnosis of renal dysfunction in DKD,which has important clinical significance in the early diagnosis and treatment of DKD.
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Received: 26 March 2020
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