Application Value Of Integrated Backscatter Technology In The Assessment Of Diabetic Nephropathy

Objectives To detect backscattering integral values of the different clinical stage of diabetic nephropathy by ultrasonic backscatter technology. To explore IBS technology's value in evaluating DKD clinical staging diagnosis as quantitative imaging method.Methods 1 131 diabetes with glomerular filtration rate increased and diabetic nephropathy were divided into?group(diabetes with glomerular filtration rate increased,n=41), ?group(early diabetic nephropathy, n=30), ? group(clinical diabetic nephropathy, n=30), ?group(end-stage diabetic nephropathy, n=30), during the same period healthy volunteers were divided into?group(stage?, n=140) from November2014 to February 2016 in the affiliated Hospital of North China University of Science and Technology. 2 First of all, adjusting the equipment during the experiment; and then,studing analyzes DKD patients and healthy adults' cortex of kidney, medulla, renal sinus through IBS technology using American HP 5500 ultrasonic equipment; finally, setting the conditions remain unchanged, subject the prone position or lateral position, in IBS imaging conditions, at this time, get kidney standard coronal section, patient is asked to hold your breath, and admission image during hold your breath on the magneto-optical disc, after that off the image measurement and analysis. Ultrasonic parameters include peak- peak intensity(PPI), the average image intensity(AII) and standard deviation of image intensity(SDI). And the AII of renal cortex and medulla was standardized, renal cortex AII% =(cortex AII / renal sinus AII) × 100%, medullary AII% =(medulla AII /renal sinus AII) × 100%. 3 Excel was used to establish a database, SPSS17.0 statistical analysis software was used for statistical analysis, all measurement data used by mean±standard deviation(sx ±). Counting information were expressed as percent, their comparison used chi-squared test. The means comparison in several groups used one-way ANOVA. Test standard: P<0.05; The Spearman rank correlation test course of different stage of diabetic nephropathy with renal parenchyma backscattering of the correlation between integral value; The ultrasonic parameter with statistical difference were analyzed by ROC curve, and diagnostic thresholds for diabetic nephropathy and its different stages were analyzed.Results 1 With the clinical progression of diabetic nephropathy, AII value gradually increased significantly; 2 The result for all groups, IBS of renal sinus is highest, cortex is secondary, and medulla is lowest, the three different significantly(P<0.05); 3 With the prolnged history of diabetes, diabetic nephropathy gradually progress. The comparison of the standardized average image intensity(AII%) of renal cortex and renal medulla among all groups showed that?group<?group<?group<?group<?group(P<0 05); 4 renla cortex and renal medulla AII, AII% with progression of diabetic nephropathy have good correlation, and AII% have the better correlation with progression of diabetic nephropathy, AII of renal cortex correlation coefficient rs=0.553, AII% of renal cortex correlation coefficient rs=0.874, AII of renal medulla correlation coefficient rs=0.548,AII% of renal medulla correlation coefficient rs=0.861; 5 ROC curve analysis reveaved that area under the curves of renal cortex AII% and renal medulia AII% for diabetic nephropathy and its different stages were more than 0.7(P<0.05). The diagnostic boundary value of renal cortex AII% for diabetic nephropathy, stage?, stage ?, stage?and stage?were 0.722, 0.741, 0.783 and 0.813. And the diagnostic boundary value of renal medulla AII% for diabetic nephropathy, stage?, stage ?, stage ? and stage?were 0.620, 0.653, 0.693 and 0.725..Conclusions 1 As the clinical progress of diabetic nephropathy, renal cortex and renal medulla's AII and AII % value increased gradually; 2 AII of renal cortex,renal medulla and renal sinus are obviously different; 3 renal cortex and renal medulla's AII and AII%have the better relation with the clinical stage of DKD; 4 the renal cortex and renal medulla's AII% can become the better diagnostic indicators in DKD clinical staging; 5IBS technique can be a quantitative analysis on the different clinical stages of DKD, to objectively evaluate clinical progress of DKD.