Value of virtual touch tissue quantification technique in evaluating renal damage in patients with diabetic nephropathy

doi:10.3877/cma.j.issn.1672-6448.2020.12.016

Abstract

Abstract:

Objective

To evaluate the value of virtual touch tissues quantification (VTQ) in the diagnosis of diabetic nephropathy (DN).

Methods

Seventy-nine patients who were clinically diagnosed with diabetes at the Department of Endocrinology, Affiliated Hospital of Southwest Medical University from March 2017 to March 2019 were collected. According to the urinary albumin excretion rate (UAER), they were divided into a minimal microalbuminuria group (n=31), microalbuminuria group, (n=27) and massive albuminuria group (n=21). Thirty healthy people were selected as a healthy control group. The renal cortex shear wave velocity (SWV) of each group was measured by VTQ technique. The difference of SWV among different groups was compared by one-way ANOVA, and LSD-t test for pairwise comparison between groups. Pearson correlation analysis was used to analyze the correlation of change of SWV value with UAER. The receiver operating characteristic (ROC) curve of SWV was plotted to determine its performance in the diagnosis of early DN.

Results

With the aggravation of renal parenchyma damage in DN patients, the SWV value decreased gradually; the SWV values of the healthy control group, minimal microalbuminuria group, microalbuminuria group, and massive albuminuria group were (3.31±0.45) m/s, (3.12±0.35)m/s, (2.56±0.08) m/s, and (1.96±0.07) m/s, respectively. The SWV values of the microalbuminuria group and massive albuminuria group were significantly lower than those of the healthy control group and minimal microalbuminuria group (t=8.973, 16.155, 8.653, 17.931, P<0.001). There was a negative correlation between renal cortex SWV and UAER (r= -0.802, P<0.01). The area under the curve of SWV for diagnosis of early DN was 0.783. When the cut-off value was 3.31 m/s, the sensitivity and specificity were 86.2% and 70%, respectively.

Conclusion

VTQ technique can noninvasively quantitatively evaluate the renal parenchyma elasticity changes of DN patients. SWV has a good negative correlation with UAER, which is an effective index to evaluate early renal damage in DN patients.

Key words: Virtual touch tissues quantification, Diabetes, Nephropathy, Diagnosis

Wen Fan, Yuanming He, Mingxing Li. Value of virtual touch tissue quantification technique in evaluating renal damage in patients with diabetic nephropathy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(12): 1231-1235.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.12.016

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I12/1231

Figures/Tables 4

References 17

1	伊蒙. 糖尿病肾脏疾病治疗的研究进展 [J]. 肾脏病与透析肾移植杂志, 2016, 25(5): 54-56.
2	李静, 梁田田, 王文健. 糖尿病肾病的早期诊断 [J]. 中华肾脏病杂志, 2017, 33(6): 470-475.
3	马屹茕, 丁国华. 线粒体稳态与糖尿病肾病研究新进展 [J]. 中华肾脏病杂志, 2016, 32(11): 872-875.
4	郑一君, 陈庆, 龚丽萍, 等. 不同病理分期的糖尿病肾病超声弹性表现 [J]. 中国超声医学杂志, 2016, 32(7): 622-625.
5	Bob Fl, Grosu I, Sporea I. et al. Ultrasound-based shear wave elastography in the assessment of patients with diabetic kidney disease [J]. Ultrasound Med Biol, 2017, 43(10): 2159-2166.
6	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2013年版) [J]. 中国糖尿病杂志, 2014, 30(8): 26-89.
7	Mogensen CE. Natural history of renal functional abnormalities in human diabetes mellitus:From normoalbuminuria to incipient and overt nephropathy//Brenner BM, Stein JH. The kidney in Diabetes Mellitus [M]. New York: Livingstong, 1989: 19-49.
8	董学勤, 安艳荣, 谭宓, 等. 同型半胱氨酸及超敏C反应蛋白与2型糖尿病颈动脉内膜-中层厚度的相关性研究 [J]. 临床内科杂志, 2016, 33(5): 333-334.
9	张海林. 尼莫地平联合奥拉西坦胶囊治疗老年2型糖尿病合并轻度认知功能障碍患者的疗效观察 [J]. 感染、炎症、修复, 2017, 18(4): 221-223.
10	杨敏芳, 杨海超, 李晶, 等. 声触诊组织定量技术在慢性肾病诊断中的应用及影响因素[J/CD]. 中华医学超声杂志(电子版), 2016, 13(2): 108-112.
11	杨雪, 王正滨, 于宁, 等. 声触诊组织定量评价儿童原发性肾病综合征肾间质纤维化的应用价值 [J]. 中国超声医学杂志, 2016, 32(4): 340-342.
12	Bob F, Grosu I, Sporea I, et al. Is there a correlation between kidney shear wave velocity measured with VTQ and histological parameters in patients with chronic glomerulonephritis? A pilot study [J]. Med Ultrason, 2018, 1(1): 27.
13	徐娟, 唐毅, 陈镜宇, 等. 声触诊组织定量技术检测正常儿童肾皮质弹性 [J]. 中国医学影像技术, 2016, 32(2): 291-294.
14	Betz BB, Jenks SJ, Cronshaw AD, et al. Urinary peptidomics in a rodent model of diabetic nephropathy highlights epidermal growth factor as a biomarker for renal deterioration in patients with type 2 diabetes [J]. Kidney Int, 2016, 89(5): 1125-1135.
15	于梦霞, 戚庭月, 於晓平, 等. 糖尿病肾病肾实质剪切波速度与肾动脉血流参数的相关性分析 [J]. 临床超声医学杂志, 2018, 20(3): 173-176.
16	胡巧, 康利克, 王小燕, 等. 声触诊组织定量分析技术分期诊断慢性肾病 [J]. 中国医学影像技术, 2014, 30(3): 453-456.
17	张之杰, 王正滨, 张涛, 等. 声触诊组织定量分析对糖尿病肾病的临床应用价值 [J/CD]. 中华医学超声杂志(电子版), 2013, 10(7): 580-584.

组别	例数	男/女（例）	年龄（岁）	尿素氮（mmol/L）	血肌酐（μmol/L）	空腹血糖（mmol/L）	三酰甘油（mmol/L）
健康对照组	30	16/14	48.33±7.55	5.09±0.45	65.35±5.72	4.67±0.70	1.22±0.11
极微量蛋白尿组	31	18/13	44.74±6.79	5.51±1.06	68.35±6.21	9.89±0.89^a	1.27±0.11
微量蛋白尿组	27	15/12	49.67±7.30	5.54±1.07	74.43±6.17^ab	10.04±0.86^a	1.67±0.18^ab
大量蛋白尿组	21	11/10	49.29±7.51	5.24±1.03	89.96±7.22^abc	10.31±0.87^a	1.69±0.17^ab
统计值		χ²=0.213	F=2.773	F=1.565	F=72.041	F=305.891	F=83.423
P值		0.975	0.045	0.202	<0.001	<0.001	<0.001

组别	例数	男/女（例）	年龄（岁）	尿素氮（mmol/L）	血肌酐（μmol/L）	空腹血糖（mmol/L）	三酰甘油（mmol/L）
健康对照组	30	16/14	48.33±7.55	5.09±0.45	65.35±5.72	4.67±0.70	1.22±0.11
极微量蛋白尿组	31	18/13	44.74±6.79	5.51±1.06	68.35±6.21	9.89±0.89^a	1.27±0.11
微量蛋白尿组	27	15/12	49.67±7.30	5.54±1.07	74.43±6.17^ab	10.04±0.86^a	1.67±0.18^ab
大量蛋白尿组	21	11/10	49.29±7.51	5.24±1.03	89.96±7.22^abc	10.31±0.87^a	1.69±0.17^ab
统计值		χ²=0.213	F=2.773	F=1.565	F=72.041	F=305.891	F=83.423
P值		0.975	0.045	0.202	<0.001	<0.001	<0.001

组别	例数	UAER（mg/d）	SWV（m/s）
健康对照组	30	2.92±1.64	3.31±0.45
极微量蛋白尿组	31	10.68±1.73^a	3.12±0.35
微量蛋白尿组	27	105.57±33.32^ab	2.56±0.08^ab
大量蛋白尿组	21	392.47±42.53^abc	1.96±0.07^abc
F值		1247.246	97.521
P值		<0.001	<0.001

组别	例数	UAER（mg/d）	SWV（m/s）
健康对照组	30	2.92±1.64	3.31±0.45
极微量蛋白尿组	31	10.68±1.73^a	3.12±0.35
微量蛋白尿组	27	105.57±33.32^ab	2.56±0.08^ab
大量蛋白尿组	21	392.47±42.53^abc	1.96±0.07^abc
F值		1247.246	97.521
P值		<0.001	<0.001

[1]	Jinmei He, Lixue Yin, Jing Tan, Wenjun Zhang, Rui Wang, Mei Ren, Mingjiao Liao. Evaluation of potential left ventricular systolic dysfunction in patients with type 2 diabetes mellitus using ultrasonic myocardial work technology [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1029-1035.
[2]	Shuihua Yang, Guidan He, Guican Qin, Mengfeng Liang, Yanhe Luo, Xueqin Li, Juansong Tang. Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1061-1067.
[3]	Heng Lyu, Licong Dong, Haiqin Xie, Zhuofei Zhao, Li Liu, Desheng Sun. CT-ultrasound comparison for evaluating missed diagnosis of focal liver lesions by ultrasound: a single-center cross-sectional quality control survey [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 712-716.
[4]	Peijie Li, Yongjie Qiao, Haoqiang Zhang, Jiankang Zeng, Fei Tan, Jiahuan Li, Jing Wang, Shenghu Zhou. Progress in diagnosis and treatment of periprosthetic infection with negative bacterial culture [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 827-833.
[5]	Xu Peng, Yongfu Shao, Duo Li, Rui Zhou, Zhenming Xing. Diagnosis and surgical treatment of hepatocolon flexure [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 108-110.
[6]	Zhiming Li, Chenming Guo, Xiaochen Zhuang, Xueqin Hou, Junxi Gao. Comparative study of qualitative and quantitative indicators of contrast-enhanced ultrasound in early breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 639-643.
[7]	Xue Yang, Wei Zhang, Peizhong Shang, Chuangye Song, Dandan Shang, Wei Zhang. Cholecystoduodenal fistula with stone draining through it and spontaneously healing：a case report [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 707-708.
[8]	Ming Jiang, Rui Luo, Chengchao Long. Diagnosis and treatment of obturator hernia: An experience of 73 cases over 10 years [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 706-710.
[9]	Dingwei Xu, Jiangyun Ma, Xincheng Li, Jie Huang. Alagille syndrome misdiagnosed as congenital biliary atresia: a case report and literature review [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 681-687.
[10]	Bing Lan, Huaiming Wang, Hui Wang, Bo Ma. Research progress on locally advanced colon cancer with bladder invasion [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 505-511.
[11]	Hongjie Yang, Zhichun Zhang, Yi Sun. Study progress in the diagnosis of lymph node metastasis of rectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 512-518.
[12]	Lili Zhao, Kuixiang Wang, Xiaochong Zhang, Zhiyuan Li. Diagnostic value of ESR to C-Reactive protein ratio in diagnosis of periprosthetic joint Infection [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(06): 351-355.
[13]	Meng Wu, Guozhong Wu, Guihong Wang, Liangliang Duan, Jie Shi, Xu Wang, Ting Yu, Wei Liu. Correlation between neutrophil-lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in patients with IgA nephropathy [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 972-979.
[14]	Nianyu Xue, Shengmin Zhang, Lingheng Wu, Lei Sha, Lanyue Tong, Cuiqin Shen, Zhaojun Li, Lianfang Du. Effect of serum bilirubin on myocardial function in patients with type 2 diabetes before cardiac structural changes [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 1004-1009.
[15]	Tian Li, Hong Xu, Heliang Liu. Progress in research of pneumoconiosis [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 900-905.

Please choose a citation manager

Content to export