| Part 1 Real-time shear wave elastography on normal KidneyObjective:Real-time shear wave elasticity imaging technology was used to carry out elasticity quantitative study on normal human renal,the range of normal human renal elasticity is obtained,which lay the foundation for later evaluation of the function and structure of renal disease.Methods:From January 2017 to December 2017,200 cases of normal in physical examination center of the fourth affiliated hospital of Kunming Medical University were selected,age 8-80 years old,average(42.33 ± 18.90)years old.Of these,100 were males,with an average age of(43.58±19.23)and 100 females,with an average age of(41.60± 18.69)years.All subjects were divided into male group and female group according to gender,male group:M1-M4 group,female group:F1-F4 group.Divided into 4 groups according to age,N1-N4 group:N1 group:36 people 8-20 years old average(15.00±4.27)years old;Male 19,female 17;N2 group:58 people 21-40years old average(31.78 ±5.53)years old;Male 30,female 28;N3 group:65 people 41-60 years old average(50.12 ± 5.17)years old;Male 31,female 34;N4 group:41 people 61-80 years old average(68.90 ±4.90)years old.Male 20,female 21;Using the French Supersonic Imagine’s Aix-plorer color Doppler ultrasound diagnostic apparatus.Start shear wave elastic imaging mode,the bilateral renal elastic modulus values were measured and the measured maximum(Max),minimum(Min),mean(Mean),and diffusion(SD)were recorded.Results:There was no significant difference(P>0.05)between the mean value of the left kidney elastic modulus(12.28±3.76)Kpa and the right kidney average elastic modulus(12.30±4.08)Kpa in normal subjects.There was no significant difference between the minimum value of the left kidney elastic modulus(7.15±4.26)Kpa and the right kidney minimum elastic modulus(6.80±4.61)Kpa in the normal subjects(P>0.05).There was no significant difference between the maximum value of the left kidney elastic modulus(19.80±4.83)Kpa and the right kidney elastic modulus(20.05±4.59)Kpa in normal subjects(P>0.05).There was no significant difference in the left kidney elastic modulus dispersion(3.37±1.11)Kpa and the right kidney elastic modulus dispersion(3.53 ± 1.20)Kpa between normal subjects(P>0.05).There was no significant difference in mean,maximum,minimum,and diffusion degree of bilateral elastic modulus(P>0.05).Renal elastic modulus values of normal females were:mean(12.09 ± 3.95)Kpa,minimum(6.93 ± 4.77)Kpa,maximum(19.62 ±4.86)Kpa,and dispersion(3.48±1.21)Kpa.Renal elastic modulus values for normal males are:mean(12.49±3.88)Kpa,minimuum(6.99± 4.09)Kpa maximum(20.23±4.86)Kpa,and dispersion(3.41±1.15)Kpa.Males and females were divided into two groups by gender.There was no significant difference(P>0.05)in mean,maximum and minimum values of the renal elastic modulus between the male and female groups.There was no correlation between the average normal kidney age and age(r=0.096,P>0.05).There was no correlation between normal kidney minimum value and age(r=0.116,P>0.05).There was no correlation between normal kidney maximum value and age(r= 0.027,P>0.05).There was no significant difference in mean,maximum,and minimum values of the elastic modulus of the lower pole of the kidney among the age groups(P>0.05).The average renal elasticity values of the kidneys of normal subjects were averaged to obtain the mean(12.29 ± 3.92)Kpa,maximum(19.92 ± 4.71)Kpa,minimum(6.98 ±4.43)Kpa,and dispersion of the normal elastic modulus of the adult kidney.Degree(3.45 ± 1.16)Kpa.Conclusion:This study found that there was no significant difference between the mean,maximum,and minimum values of the elastic modulus of both kidneys,and there was no significant correlation between the elasticity of the kidneys and gender and age.The real-time shear wave elastography technique can be used to detect the range of elastic values of normal human kidneys,and a database is set up to lay a foundation for evaluating the structure and function of kidney disease.Part 2 Real-time shear wave elastography evaluate the primary nephrotic syndromeObjective:Using real-time shear wave elastography to analyze the renal elasticity of patients with primary nephrotic syndrome,to explore the differences in renal elasticity among patients with different types of primary nephrotic syndrome,and to compare with the normal group in order to evaluate the real-time shear.Application value of shear elasticity imaging in structural and functional changes of kidney diseases.Methods:51 patients with clinically diagnosed primary nephrotic syndrome were selected,aged 14-75 years old,with an average age of(43.94 ± 17.28)years.There were 34 males and 17 females.According to their pathological classification,they were divided into 5 groups:MCN group:7 cases of minimal change nephropathy group;MCGN group:10 cases of mesangial capillary glomerulonephritis group;MsPGN group:15 cases of mesangial proliferative glomerulonephritis group;MN group:13 cases of membranous nephropathy group;FSGS group:6 cases of egmental glomerulosclerosis group.The first part of the 200 normal people group was set as a control group.The shear wave elastography(SWE)mode was started to detect the average(Mean),maximum(Max),minimum(Min),and diffuse(SD)elastic modulus of the bilateral kidneys.Results:The right kidney elastic modulus range in the nephrotic syndrome group:Mean(19.74 ± 8.05)Kpa,Min(12.99 ± 8.43)Kpa,Max(27.10 ± 8.30)Kpa,and SD(3.38 ±1.00)Kpa;nephrotic syndrome group left kidney The elastic modulus values ranged from Mean(18.95 ± 6.20)Kpa,Min(11.13±6.02)Kpa,Max(26.22±6.28)Kpa,and SD(3.56±0.95)Kpa.There was no significant difference in mean,maximum,minimum,and diffusion modulus of the right kidney and left kidney in the nephrotic syndrome group(P>0.05).A total of 102 kidneys were combined with nephrotic syndrome group.The range of the modulus of kidney elasticity of nephrotic syndrome group was Mean(19.35 + 7.12)Kpa,Min(12.06 + 7.22)Kpa,Max(26.66 + 7.29)Kpa and SD(3.47 +0.98)Kpa.Renal elastic modulus values in the nephrotic syndrome group ranged from Mean(19.35 ± 7.12)Kpa,Min(12.06 ± 7.22)Kpa,Max(26.66 ± 7.29)Kpa,and SD(3.47 ±0.98)Kpa;normal human renal elastic modulus Value range:Mean(12.29 ±3.92)Kpa,Min(6.98±4.43)Kpa,Max(19.92±4.71)Kpa,and SD(3.45± 1.16)Kpa.The mean,maximum and minimum values of the elastic modulus of the kidneys in the nephrotic syndrome group and the normal group were significantly different(P<0.05).The nephrotic syndrome group’s renal elasticity value was significantly greater than that of the normal group.The comparison of the elasticity values of kidneys in each pathological type of nephrotic syndrome:The mean,maximum and minimum values of the elastic modulus of the two kidneys in the normal group,the MCN group and the MCGN,MsPGN,MN group and FSGS groups were significantly different(P<0.05).The elastic modulus values of kidneys in MCGN,MsPGN,MN group and FSGS groups were significantly higher than those in MCN group and the normal group;There was no significant difference between the normal group and the MCN group in the mean value,the maximum and the minimum value of the elastic modulus of the two kidneys(P>0.05).MCGN,MsPGN,MN groups and FSGS pairs of two comparisons,the two kidneys elastic modulus,the average,the maximum,the minimum was no significant difference(P>0.05).Conclusion:There was no significant difference in bilateral renal elastic modulus values in the nephrotic syndrome group,suggesting that nephrotic syndrome caused by different causes has the same damage to the bilateral kidneys.The real-time shear wave elastography in the nephrotic syndrome group had significant differences in the renal elasticity values between the nephrotic syndrome group and the normal group.The renal elastic modulus value of the nephrotic syndrome group was significantly higher than that of the normal group.lt is suggested that real time shear wave elastography has a certain value in the diagnosis of renal structural changes in patients with nephrotic syndrome,and the kidney hardness of patients with nephrotic syndrome is higher than that of normal people.Compared with the normal group,there was no significant difference between the normal group and the normal group.The renal elastic values of the patients with small disease variant nephrotic syndrome were significantly different from those of other pathological types.The renal modulus of the patients with small disease variant nephrotic syndrome was significantly lower than that of other pathological types,which indicated that the renal elastic modulus of the patients with small disease variant nephrotic syndrome was significantly lower than that of other pathological types.In several pathological types,small lesions were the lightest,mesangial proliferative glomerulonephritis,mesangial capillary glomerulonephritis,membranous nephropathy,focal segmental glomerulosclerosis,and other pathological types of nephrotic syndrome were not significantly different,indicating the kidneys of other renal syndrome groups.There were injuries,but the degree of injury was unknown. |
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