Shear-Wave Elastography Improves Diagnostic Accuracy in Chronic Kidney Disease Compared to Conventional Ultrasound.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2024-10-24 DOI:10.1002/jcu.23862

Cuiping Jiang, Shiming Zang, Qi Gao, Meili Zhao, Songwang Chen

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引用次数: 0

Abstract

Purpose: Non-invasive tests are increasingly demanded for diagnosing and prognostication of chronic kidney disease (CKD). Shear-wave elastography (SWE), an emerging technique for measuring tissue stiffness, shows promise for distinguishing between individuals with different stages of renal fibrosis. This study aimed to compare the diagnostic accuracy of two-dimensional SWE (2D-SWE) and conventional ultrasound for detecting CKD, employing renal biopsy as the gold standard.

Methods: From May 2020 to October 2023, this prospective study included 30 healthy volunteers and 169 patients with CKD who had undergone 2D-SWE and conventional ultrasound of both kidneys. Cortical and medullary stiffness, cortical pixel intensity, renal length, parenchymal and cortical thickness, interlobar artery peak systolic velocity, end-diastolic velocity (EDV), and resistive index were measured. The diagnostic accuracy of 2D-SWE and conventional ultrasound was compared using the receiver operating characteristic curve (ROC) and Delong test.

Results: For diagnosing CKD, the area under the ROC (AUC) of cortical stiffness (0.96 [95% CI, 0.93, 0.99]) was significantly higher than that of all conventional ultrasound parameters, including EDV (0.78 [95% CI, 0.71, 0.86]) and cortical thickness (0.74 [95% CI, 0.67, 0.80]). The sensitivity of cortical stiffness (91%) was significantly higher than that of EDV (68%) and cortical thickness (53%). No significant difference was found in the specificity of cortical stiffness (96%) compared to that of EDV (79%) and cortical thickness (100%).

Conclusion: Two-dimensional SWE showed higher diagnostic accuracy than that of conventional ultrasound for detecting CKD.

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与传统超声波相比，剪切波弹性成像提高了慢性肾病的诊断准确性

目的：慢性肾脏病（CKD）的诊断和预后越来越需要无创检测。剪切波弹性成像（SWE）是一种测量组织硬度的新兴技术，有望区分不同阶段的肾脏纤维化患者。本研究旨在比较二维剪切波弹性成像（2D-SWE）和传统超声检测 CKD 的诊断准确性，并将肾活检作为金标准：从 2020 年 5 月到 2023 年 10 月，这项前瞻性研究纳入了 30 名健康志愿者和 169 名接受过二维 SWE 和传统双肾超声检查的 CKD 患者。研究人员测量了皮质和髓质硬度、皮质像素强度、肾脏长度、实质和皮质厚度、叶间动脉收缩峰值速度、舒张末期速度（EDV）和阻力指数。使用接收器操作特征曲线（ROC）和德朗检验比较了二维-SWE 和传统超声波的诊断准确性：在诊断 CKD 时，皮质僵硬度的 ROC 下面积（0.96 [95% CI, 0.93, 0.99]）明显高于所有常规超声参数，包括 EDV（0.78 [95% CI, 0.71, 0.86]）和皮质厚度（0.74 [95% CI, 0.67, 0.80]）。皮质硬度的灵敏度（91%）明显高于 EDV（68%）和皮质厚度（53%）。皮质僵硬度的特异性（96%）与 EDV（79%）和皮质厚度（100%）相比无明显差异：结论：二维SWE检测CKD的诊断准确性高于传统超声。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.