Application Of Real-time E Imaging And Ultra-micro-flow Imaging In Diagnosis Of Chronic Kidney Disease

Objective:Using real-time shear wave elastography and ultramicro-flow phenomena to quantitatively measure the subpolar cortex of the left kidney in healthy people and patients with chronic kidney disease,to determine whether there are differences in renal cortical hardness and blood perfusion between healthy people and patients with chronic nephropathy,and whether there are differences in renal cortical hardness and blood perfusion in different periods,to discuss the correlation between renal cortical hardness and blood flow perfusion,renal function laboratory examination,related history,and lay a foundation for the clinical study of chronic nephropathy in the future.Methods:From June to December 2020,71 cases were collected from Qujing Hospital affiliated to Kunming Medical University,aged 25-67 years,with an average of(46.76± 10.97)years.Among them,38 men(47.16±10.83)years old.There were 33 cases of women,average(46.30±11.27)years old.The data were divided into two groups:health group and CKD group.There were 30 people in health group.CKD group was divided into 3-4 and 5 groups according to the diagnostic criteria proposed by the United States Kidney Disease Outcome Quality Initiative(K/DOO1).There were 21 patients in CKD3-4 and 20 in CKDS.The data were collected using Supersonic Imagine company’s Aix-ploror color Doppler ultrasound diagnostic instrument,The upper and lower left kidney diameter,left and right diameter and cortical thickness were measured in two dimensional ultrasound mode,Then converted to shear wave elastic imaging(SWE)mode to Ren conditions,The elastic modulus values of three different points at the lower pole of the left kidney were measured,and record the maximum(Emax),(Emin),mean(Emean),dispersion(SD),And then start the ultramicro blood flow imaging(Ap)pattern,To observe the blood flow in the left inferior polar cortex,The renal function laboratory index blood creatinine Scr(μmol/L),urea nitrogen BUN(mmol/L),albumin Alb(g/L)were recorded and the glomerular filtration rate eGFR(mL/min/1.73m~2)was calculated and recorded according to the number of blood flow displayed.Patients with CKD5 period recorded hypertension,diabetes and hemodialysis time.Results:There was no significant difference in age,sex,BMI dispersion coefficient SD healthy people and CKD3-5 patients.(p>0.05).There was significant difference between the upper and lower diameter of the left kidney and the upper and lower diameter of the left kidney in CKD3-5 patients(p<0.05),there was significant difference between left and right kidney diameter in healthy people and left and right kidney diameter in CKD3-5 patients(p<0.05),there was significant difference in left renal cortex thickness between healthy people and CKD3-5 patients(p<0.05).The mean value of renal modulus of elasticity in healthy people Mean compared with Mean mean value of renal modulus of elasticity in CKD3-5 patients(p<0.05),there was significant difference between the maximum Max of renal elastic modulus in healthy people and Max maximum of renal elastic modulus in CKD3-5 patients(p<0.05),there was significant difference minimum Min of renal modulus of elasticity in healthy people and Min minimum of renal modulus of elasticity in CKD3-5 patients was statistically significant(p<0.05).The blood flow in the left inferior pole cortex of 1.healthy people was significantly different from that in CKD3-5 patients(p<0.05).The laboratory results of CKD patients and healthy people were different(p<0.05),CKD serum creatinine and urea nitrogen were significantly higher in patients than in healthy patients.There was no significant correlation between the elastic modulus values of CKD group and laboratory data(serum creatinine,urea nitrogen,albumin,glomerular filtration rate)(p>0.05).CKD,there was no correlation between renal modulus and time of hypertension and diabetes(p>0.05),the mean value of elastic modulus of CKD kidney Mean correlated with hemodialysis time(r=0.328,p<0.05),the maximum Max of renal elastic modulus in CKD patients was correlated with hemodialysis time(r=0.357,p<0.05).CKD groups were divided into 3-4 groups and 5 groups according to stages:the upper and lower diameters,left and right diameters and cortical thickness of the two groups were not significantly different(p>0.05),there was no significant difference between the values of renal elastic modulus of CKD3-4 patients and those of CKD5 patients(p>0.05),there was no significant difference between the blood flow in the left inferior polar cortex in CKD3-4 patients and that in CKD5 patients(p>0.05).There was no significant difference between CKD3-4 and CKD5 hypertension,diabetes and dialysis(p>0.05),CKD3-4 period has gout 6 people,CKD5 period has gout 3 people.And there was no significant difference between the distribution of disease and CKD staging(p>0.05).Conclusion:Routine two-dimensional ultrasound can be used to detect renal structural changes in middle and late renal injury,but chronic nephropathy can not be staged.Shear wave elastography can be used to evaluate the degree of renal fibrosis in middle and late renal injury,but the staging diagnosis of chronic nephropathy needs larger sample,multi-queue studies to confirm.Ultramicro blood flow imaging can be used to evaluate the changes of peripheral blood flow perfusion during middle and late renal injury,but the diagnosis of different stages of chronic nephropathy needs further confirmation.The Emean、Emax of elastic modulus of CKD group is related to the duration of dialysis.The difference of dialysis duration may be a factor affecting the change of elastic modulus of end-stage kidney in chronic nephropathy.It is proved that the correlation between dialysis duration and end-stage renal injury is a clinical problem to be discussed.