Diagnostic Value of Conventional Ultrasound Combined with Shear Wave Elastography for Sarcopenia in Patients with Chronic Kidney Disease
[Objective]To explore the diagnostic value of conventional ultrasound combined with shear wave elastography (SWE) for sarcopenia in patients with chronic kidney disease (CKD).[Methods]The study included 94 CKD patients (34 with sarcopenia and 60 without). All patient underwent the Simplified Assessment Rating Questionnaire (SARC-CalF),Mini Nutritional Assessment (MNA),Short Physical Performance Battery (SPPB),grip strength test,bioelectrical impedance analysis (BIA),conventional muscle ultrasound and SWE of the thighs. We then compared the differences in indicators between the sarcopenia group and non-sarcopenia group,used Spearman correlation analysis to assess the relationship between the two examinations (conventional ultrasound and SWE) and other clinical indicators,identified the diagnostic markers for sarcopenia,created receiver operating characteristic (ROC) curves,calculated the area under the curve (AUC) and determined the diagnostic performance of conventional ultrasound,SWE and their combination. Binary logistic regression was used to analyze the influencing factors of sarcopenia in CKD patients and a combined diagnosis model was established.[Results]The sarcopenia group showed lower upper arm circumference,calf circumference,6-meter walking speed and handgrip strength than non-sarcopenia group,and the differences were statistically significant (P<0.05). The sarcopenia group exhibited lower SARC-CalF and SPBB scores,as well as more compromised nutritional status. Statistically significant differences were observed in the ultrasound parameters between the two groups,including thickness of the subcutaneous fat and rectus femoris,combined thickness of the rectus femoris and vastus intermedius,rectus femoris cross-sectional area,elastic modulus of the rectus femoris and vastus medialis (all P<0.05). The muscle mass index had a moderate positive correlation with muscle thickness and cross-sectional area of the rectus femoris (0.3<r≤0.6). The 50 kHz-leg phase angle was highly positively correlated with the rectus femoris muscle thickness (0.6<r≤0.8) and moderately positively correlated with the rectus femoris cross-sectional area,elastic modulus of the rectus femoris,vastus medialis and vastus lateralis (0.3<r≤0.6). The AUC of conventional ultrasound,SWE and their combination for diagnosis of sarcopenia in CKD patients were 0.823 (95％ CI:0.820,0.825),0.724 (95％ CI:0.718,0.725) and 0.910 (95％ CI:0.908,0.912),respectively. A predictive model incorporating seven indicators was established,with an AUC of 0.914 (95％ CI:0.913,0.916),a sensitivity of 0.952 and specificity of 0.808.[Conclusions]Conventional ultrasound combined with SWE can be used as a simple and effective method to detect sarcopenia in patients with CKD and provide a reliable basis for early clinical intervention.
sarcopeniachronic kidney diseaseshear wave elastographyconventional ultrasounddiagnostic value
万方数据
维普
