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目的声辐射力脉冲(ARFI)成像技术是通过测量组织剪切波速度来定量评价组织弹性的一项超声技术,目前该技术已被广泛应用于各种器官。本实验采用超声测定移植肾皮质剪切波速度,研究施加压力参数变化对组织剪切波速度变异的影响以及评估ARFI成像技术检测移植肾肾纤维化的诊断价值。方法本实验中测定31例移植肾肾皮质的剪切波速度,以穿刺活检结果为金标准。机器测定并施加探头压力的等效质量分别为:22、275、490、975、2040及2990g。结果 ANOVA统计学分析表明,剪切波速度与探头施压参数有关,差异具有统计学意义[F(2.85,85.91)=84.75,P<0.0005;施加的质量分别为22、275、490、975和2040g]。31例移植肾中有29例活检结果,移植肾纤维化程度为:12例0级,11例1级,5例2级,1例3级。单因素方差分析表明,针对不同纤维化程度,移植肾皮质剪切波速度差异不具有统计学意义。结论剪切波速度的测量值与施压大小有关,而与移植肾纤维化程度无关。要点①超声检查中的ARFI成像技术能定量评估组织弹性。②ARFI评估移植肾弹性与探头施压大小有关。③ARFI技术无法定量评估移植肾纤维化程度。④ARFI弹性评估会因施压的改变而改变。
Objective The acoustic emission pulse (ARFI) imaging technique is an ultrasound technique for the quantitative evaluation of tissue elasticity by measuring tissue shear wave velocity, which has been widely used in various organs at present. In this study, we measured the shear wave velocity of transplanted renal cortex with ultrasound, studied the effect of pressure parameters on the variation of tissue shear wave velocity, and evaluated the diagnostic value of ARFI imaging in detecting renal allograft fibrosis. Methods In this experiment, the shear wave velocity of 31 cases of renal allograft was measured, and the biopsy results were the gold standard. Equivalent masses measured and applied by the machine for probe pressure were 22,275,490,975,2040 and 2990g, respectively. Results ANOVA statistical analysis showed that the shear wave velocity was related to the probe pressure parameters, the difference was statistically significant [F (2.85,85.91) = 84.75, P <0.0005; the applied mass were 22,275,490,975 and 2040g]. Thirty-one of the 31 transplant recipients had biopsy results, and the degree of graft-versus-fibrosis was 12 grade 0, 11 grade 1, 5 grade 2, and 1 grade 3. Univariate analysis of variance showed that there was no significant difference in the velocity of transcortical renal cortical shear wave for different degrees of fibrosis. Conclusion The measurement of shear wave velocity is related to the magnitude of pressure exertion, but not to the extent of renal graft fibrosis. Key points ① The ARFI imaging technique in ultrasonography allows quantitative assessment of tissue elasticity. ② ARFI assessment of graft elasticity and probe pressure on the size. ③ ARFI technology can not quantitatively assess the degree of renal graft fibrosis. ④ ARI elastic assessment will change due to pressure changes.