The Clinical Value Of Real-time Shear Wave Elastography For Eva Luating Type 2 Diabetic Kidney Disease

Objective: To quantitative analyze the Young’s modulus of renal cortex in patients with type 2 diabetes mellitus,type 2 diabetic kidney disease and normal human using the real-time shear wave elastography(SWE)technique,explore the clinical value of SWE in different stages of type 2 diabetic kidney disease and investigate the clinical reference value about SWE techniques in early diagnosis of type 2 diabetic kidney disease.Methods: The study included 20 patients with type 2 diabetes mellitus,63 patients with type 2 diabetic kidney disease and 20 healthy volunteers.63 patients with type 2 diabetic kidney disease were divided into 5 groups by the NKF-KDOQI stage.All participants underwent SWE.Renal cortex elasticity was estimated as Young’s modulus(YM)in kilopascals(k Pa).At the same time,clinical information for example age,gender,body mass index,the condition of diabetic retinopathy(DR),serum creatinine(SCr),UREA,and estimated glomerular filtration rate(e GFR)in participants was detected and recorded.The differences of clinical information and YM among different groups were compared,the correlations between the YM and clinical biochemical indicators in DKD patients and the diagnostic vaiue of SWE in DKD and staging for DKD was statistically analyzed.Result:1.With the progression of diabetes,the number of patients with DR gradually increased,SCr and UREA gradually increased,and e GFR gradually decreased.There were no significant differences in age,gender and BMI among groups(P>0.05).2.Compared with the normal kidney,the YM in DM group is significantly higher.Compared with the DM group,the YM in DKD groups are significantly higher.The pathological changes degree aggravating,YM value rise.Two both compare between normal group,DM group and DKD groups had significant difference(P<0.05),except there was no significant difference two both compare between DM group,DKD G1 group and DKD G2 group and got the same result by two both comparing the YM value of DKD G3 group,DKD G4 group,DKD G5 group.3.SCr and UREA were positively correlated with the YM value(P<0.05).e GFR was negatively correlated with the YM value(P<0.05).4.The area under the ROC curve(AUC)for the diagnosis of DKD and DKD G3-G5 in SWE was 0.857 and 0.890,the best diagnostic cut-off values were 14.21 Kpa and15.02 k Pa,respectively.Sensitivity was 71.1%and 72.1%,respectively.The specificities were 87.5% and 90.0%,respectively.Conclusion:1.SWE measurement of renal cortex elasticity value has good diagnostic efficacy assessing DKD staging.2.Compared with the normal kidney,the YM in DM group is significantly higher.3.3.The YM value in the renal cortex of DKD patients is related to the degree of renal impairment.With the aggravation of the disease,the smaller the e GFR,the higher the YM value.4.4.Real-time shear wave elastography can provide objective index and basis for DKD diagnosis and staging.