Shear wave elastography in the evaluation of fibrosis degree in renal allograft
10.3760/cma.j.cn131148-20200517-00408
- VernacularTitle:剪切波弹性成像评估移植肾纤维化程度的应用价值
- Author:
Daopeng YANG
1
;
Yan WANG
;
Bowen ZHUANG
;
Xiaoer ZHANG
;
Guangliang HUANG
;
Wenfang CHEN
;
Gang HUANG
;
Xiaohua XIE
Author Information
1. 中山大学附属第一医院超声医学科 中山大学诊断与介入超声研究所，广州 510080
- From:
Chinese Journal of Ultrasonography
2020;29(10):875-880
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of shear wave elastography imaging(SWE) in the diagnosis of renal allograft fibrosis and analyze its advantages and limitations.Methods:The renal allograft of 61 patients who underwent renal allograft biopsy from June 2019 to April 2020 in the First Affiliated Hospital of Sun Yat-sen University were included in this study. According to the Banff classification, there were 51 patients with mild-degree fibration(interstitial fibrosis/tubular atrophy, IFTA 0-Ⅰ), and 29 patients with moderate or severe-degree fibration(IFTA Ⅱ-Ⅲ). Two-dimensional ultrasound, color Doppler flow imaging, SWE and kidney function test performed. All the results were compared between the two groups. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve using pathology as gold standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for the diagnosis of moderate or severe-degree fibration.Results:Compared to mild-degree fibration group, creatinine( P<0.001), glomerular filtration rate( P<0.001), RI of arcuate arteries( P=0.022) and SWE value( P<0.001) significantly increased in the moderate or severe-degree fibration group. There were significant correlations between IFTA and creatinine ( r s=0.488, P<0.001), glomerular filtration rate ( r s=-0.452, P<0.001), RI of arcuate arteries( r s=0.228, P=0.042), SWE value( r s=0.584, P<0.001). Taking the cutoff value of SWE value deduced by ROC curve as 21.7 kPa, the area under ROC curve was 0.827. The sensitivity, specificity, positive predictive value and negative predictive value were 86.2%, 74.5%, 61.0% and 89.7%, respectively. Conclusions:There is a good correlation between the SWE value and the degree of fibrosis in the transplanted kidney. SWE can be used to distinguish mild from moderate or severe fibrosis of renal allograft, providing a potential noninvasive method for the assessment of kidney allograft fibration.
