山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (12): 68-72.doi: 10.6040/j.issn.1671-7554.0.2018.722
盛璇1,王永娥1,郭丹1,兰梦1,范凤景2,丁红宇2
SHENG Xuan1, WANG Yonge1, GUO Dan1, LAN Meng1, FAN Fengjing2, DING Hongyu2
摘要: 目的 通过分析不同体型患者声触诊组织量化成像(VTIQ)中质控模式图像,研究移植肾患者体质量指数(BMI)与移植肾皮下深度对VTIQ结果的影响。 方法 选取2017年11月至2018年5月在山东省千佛山医院接受肾移植手术及术后复查中肾功能正常患者119例。首先测量患者身高、体质量,计算BMI值;然后于移植肾皮质选择感兴趣区,测量移植肾表面与体表的距离即移植肾皮下深度;最后利用VTIQ技术获取质控模式图像并评估,将图像质量分为等级A、B、C。患者BMI和质控图像质量等级记入BMI组,患者移植肾皮下深度和质控图像质量等级记入Depth组,并对两组数据进行统计学分析。 结果 移植肾VTIQ质控模式图像质量在不同BMI患者或移植肾皮下深度之间存在差异(P<0.05)。对两组数据ROC曲线分析可知,AUC(BMI组)>AUC(Depth组),质控模式图像等级B与C之间的截断值为23.99,敏感度为0.800,特异度为0.731。 结论 移植肾VTIQ质控模式图像质量与患者BMI或移植肾皮下深度有关,BMI或者皮下深度越大,移植肾质控图像质量越差,VTIQ结果准确度越低。相对于移植肾皮下深度,患者BMI对VTIQ结果的评估具有更高的准确性。
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| [1] Tabriziani H, Lipkowitz MS, Vuong N. Chronic kidney disease, kidney transplantation and oxidative stress: a new look to successful kidney transplantation [J]. Clin Kidney J, 2018, 11(1): 130-135. [2] Solez K, Colvin RB, Racusen LC, et al. Banff-05 meeting report: differential diagnosis of chronic allograft injury and elimination of chronic allograft nephropathy(CAN)[J]. Am J Transplant, 2007, 7(3): 518-526. [3] 李嫚,刘好田,柳澄,等.基于超声弹性成像技术诊断移植肾慢性排斥反应的探索[J].中国医疗设备, 2012, 27(10): 162-165. LI Man, LIU Haotian, LIU Cheng, et al. Exploration of diagnosis of chronic rejection after kidney transplant based on ultrasonic elastrography[J]. China Medical Devices, 2012, 27(10): 162-165. [4] Monaco AP, Burke JF Jr, Ferguson RM, et al. Current thinking on chronic renal allograft rejection: issues, concerns, and recommendations from a 1997 roundtable discussion[J]. Am J Kidney Dis, 1999, 33(1): 150-160. [5] Furness PN, Taub N. Convergence of European Renal Transplant Pathology Assessment Procedures Project. International variation in the interpretation of renal transplant biopsies: report of the CERTPAP Project[J]. Kidney Int, 2001, 60(5): 1998-2012. [6] Naesens M, Kuypers DR, De Vusser K, et al. Chronic histological damage in early indication biopsies is an independent risk factor for late renal allograft failure[J]. Am J Transplant, 2013, 13(1): 86-99. [7] Seron D, Moreso F. Protocol biopsies in renal transplantation: prognostic value of structural monitoring [J]. Kidney Int, 2007, 72(6): 690-697. [8] Tsochatzis EA, Gurusamy KS, Ntaoula S, et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy [J]. J Hepatol, 2011, 54(4): 650-659. [9] Mao F, Xu HX, Zhou H, et al. Assessment of virtual touch tissue imaging quantification and the ultrasound thyroid imaging reporting and data system in patients with thyroid nodules referred for biopsy [J]. J Ultrasound Med, 2018, 37(3): 725-736. [10] Zhang Y, Zhao CK, Li XL, et al. Virtual touch tissue imaging and quantification: value in malignancy prediction for complex cystic and solid breast lesions [J]. Sci Rep, 2017, 7(1): 7807-7817. [11] Stock KF, Klein BS, Vo Cong MT, et al. ARFI-based tissue elasticity quantification in comparison to histology for the diagnosis of renal transplant fibrosis [J]. Clin Hemorheol Microcirc, 2010, 46(2-3): 139-148. [12] Kahn J, Slowinski T, Thomas A, et al. TSI ultrasound elastography for the diagnosis of chronic allograft nephropathy in kidney transplanted patients [J]. J Ultrason, 2013, 13(54): 253-262. [13] Ozkan F, Yavuz YC, Inci MF, et al. Interobserver variability of ultrasound elastography in transplant kidneys: correlations with clinical-Doppler parameters [J]. Ultrasound Med Biol, 2013, 39(1): 4-9. [14] Wang HK, Lai YC, Lin YH, et al. Acoustic radiation force impulse imaging of the transplant kidney: correlation between cortical stiffness and arterial resistance in early post-transplant period [J]. Transplant Proc, 2017, 49(5): 1001-1004. [15] 刘妍,刘聪聪,时丹丹,等.声触诊组织定量分析在肾移植术后慢性移植肾肾病诊断中的价值[J].山东大学学报(医学版), 2013, 51(8): 78-81. LIU Yan, LIU Congcong, SHI Dandan, et al. Value of virtual touch tissue quantification in the diagnosis of chronic allograft nephropathy after renal transplantation [J]. Journal of Shandong University(Health Sciences), 2013, 51(8): 78-81. [16] 姚春晓,傅宁华,杨斌,等.声触诊组织定量分析在慢性肾病中应用的初步探讨[J].中国超声医学杂志, 2009, 25(12): 1169-1172. YAO Chunxiao, FU Ninghua, YANG Bin, et al. Clinical application of virtual touch quantization in patients with nephropathy[J]. Chinese J Ultrasound Med, 2009, 25(12): 1169-1172. [17] 傅宁华,杨斌,姚春晓,等.声触诊组织定量分析评估慢性肾病患者肾脏弹性[J].中华医学超声杂志, 2010, 7(12): 2122-2126. FU Ninghua, YANG Bin, YAO Chunxiao, et al. A pilot study of virtual touch quantization in patients with chronic kidney disease [J]. Chin J Med Ultrasound, 2010, 7(12): 2122-2126. [18] 曾碧丹,祝志敏,陈菲,等.超声弹性成像定量分析技术诊断慢性移植肾肾病的临床应用研究[J].中国临床医学影像杂志, 2014, 25(3): 179-181. ZENG Bidan, ZHU Zhimin, CHEN Fei, et al. Quantitative analysis of ultrasonic elastography in the diagnosis of chronic allograft nephropathy: a clinical application study [J]. J Chin Clin Med Imaging, 2014, 25(3): 179-181. [19] Syversveen T, Brabrand K, Midtvedt K, et al. Assessment of renal allograft fibrosis by acoustic radiation force impulse quantification: a pilot study[J]. Transpl Int, 2011, 24(1): 100-105. [20] Juhan L, Young TO, Dong JJ, et al. Acoustic radiation force impulse measurement in renal transplantation: a prospective, longitudinal study with protocol biopsies [J]. Medicine, 2015, 94(39): 1590-1596. [21] 戴茜,刘明辉,郭勇,等.移植肾纤维化的声触诊定量评估[J].中南大学学报(医学版), 2014, 39(2): 173-177. DAI Xi, LIU Minghui, GUO Yong, et al. Noninvasive evaluation of renal allograft fibrosis by virtual touch tissues quantification [J]. J Cent South Univ(Med Sci), 2014, 39(2): 173-177. [22] Lukenda V, Mikolasevic I, Racki S, et al. Transient elastography: a new noninvasive diagnostic tool for assessment of chronic allograft nephropathy[J]. Int Urol Nephrol, 2014, 46(7): 1435-1440. [23] Early H, Aguilera J, Cheang E, et al. Challenges and considerations when using shear wave elastography to evaluate the transplanted kidney, with pictorial review [J]. J Ultrasound Med, 2017, 36(9): 1771-1782. [24] Bota S, Bob F, Sporea I, et al. Factors that influence kidney shear wave speed assessed by acoustic radiation force impulse elastography in patients without kidney pathology[J]. Ultrasound Med Biol, 2015, 41(1): 1-6. [25] Wang Z, Yang H, Suo C, et al. Application of ultrasound elastography for chronic allograft dysfunction in kidney transplantation[J]. J Ultrasound Med, 2017, 36(9): 1759-1769. |
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