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目的探讨声触诊组织定量分析(VTQ)技术在诊断肾移植术后慢性移植肾肾病(CAN)中的价值。方法选择CAN患者28例(CAN组),同期选择肾功能正常的33例移植肾患者为对照组,均进行常规超声检查及VTQ检查,并对检查结果进行对比分析。结果 CAN组剪切波速度(SWV)平均值为(3.03±0.23)m/s,对照组肾实质的SWV平均值为(2.71±0.23)m/s,两者比较差异具有统计学意义(P<0.05);用受试者工作特征(ROC)曲线分析,以SWV≥2.83 m/s为截断值时,诊断CAN的敏感性为92.9%、特异性为66.7%、阳性预测值为70.3%、阴性预测值为91.7%,诊断准确度为78.7%。结论 VTQ可以定量评价移植肾肾实质的弹性变化,并可提供常规超声之外的诊断信息。
Objective To investigate the value of quantitative palpation (VTQ) in the diagnosis of chronic allograft nephropathy (CAN) after renal transplantation. Methods Twenty-eight CAN patients (CAN group) were selected. In the same period, 33 renal transplant recipients with normal renal function were selected as control group. All patients underwent routine ultrasonography and VTQ examinations, and the results were compared. Results The mean value of SWV was (3.03 ± 0.23) m / s in CAN group and (2.71 ± 0.23) m / s in control group, and the difference was statistically significant (P <0.05). Using ROC curve analysis, the sensitivity of CAN was 92.9%, the specificity was 66.7% and the positive predictive value was 70.3% when the SWV was 2.83 m / s, The negative predictive value was 91.7% and the diagnostic accuracy was 78.7%. Conclusion VTQ can quantitatively evaluate the elastic changes of parenchymal renal allografts and provide diagnostic information beyond conventional ultrasound.