Real-time shear wave elastography combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease
10.13929/j.issn.1003-3289.2024.08.024
- VernacularTitle:实时剪切波弹性成像联合生化指标评估慢性肾脏病患者肝损伤
- Author:
Xiangyang FAN
1
;
Yan ZHANG
;
Xiao HE
;
Ziwei WANG
;
Jing YU
Author Information
1. 郑州大学第一附属医院超声科,河南郑州 450052
- Keywords:
renal insufficiency,chronic;
hepatic insufficiency;
ultrasonography
- From:
Chinese Journal of Medical Imaging Technology
2024;40(8):1221-1225
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the value of real-time shear wave elastography(SWE)combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease(CKD).Methods Totally 210 patients with CKD(CKD group)and 64 healthy subjects(control group)were retrospectively enrolled.Patients in CKD group were further divided into CKD1-5 subgroups according to CKD stages.SWE parameters of liver and kidney,including mean value,the maximum value and the median value of Young's modulus(EQImean,EQImax and EQImed)were compared between CKD subgroups and control group.Spearman correlation analysis were performed to explore the correlations of liver and kidney SWE parameters with CKD stage,as well as of liver SWE parameters with biochemical indicators.Multivariate logistic regression analysis was used to screen independent predictors of liver injury in CKD patients.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of the independent predictors alone and their combination for assessing liver injury in CKD patients.Results Significant differences of liver and kidney SWE parameters were found among CKD subgroups and control group(all P≤ 0.001).Pairwise comparison showed that liver SWE parameters in CKD5 subgroup and liver EQImax in CKD4 subgroup were all higher than those in control group(all P＜0.003).Kidney SWE parameters in CKD3 subgroup were all higher than those in control group,while in CKD4 subgroup were all higher than those in control group and CKD1-3 subgroup(all P＜0.003).Kidney EQImean and EQImed in CKD5 subgroup were all higher than those in control group and CKD1-4 subgroup,while kidney EQImax in CKD5 subgroup were higher than those in control group and CKD1-3 subgroup(all P＜0.003).Liver and kidney SWE parameters were lowly-moderately and positively correlated with CKD stages(r=0.364-0.665,all P＜0.001).Liver SWE parameters of CKD were weakly and positively correlated with alkaline phosphatase(ALP)(r=0.229-0.248,all P＜0.01).The γ-glutamyl transferase,ALP and liver EQImax were all independent predictors of liver injury in CKD patients(all P＜0.01),with AUC for evaluating liver injury in CKD patients alone of 0.645,0.756 and 0.741,respectively,lower than that of their combination(0.851,all P＜0.01).Conclusion Real-time SWE combined with liver function indicators could reflect degree of liver injury in patients with different CKD stages.
