Multiparametric Ultrasonography Integrating Viscoelastic Imaging and Microvascular Ultrasound for Diagnosis and Staging of Chronic Kidney Disease.

OBJECTIVE

This study aimed to evaluate the diagnostic value of multiparametric ultrasound, comprising elastic modulus (Emean), viscosity coefficient (Vmean), and microvascular ultrasound (MVUS) grading, for chronic kidney disease (CKD) diagnosis and staging.

METHODS

This prospective study enrolled 88 CKD patients and 49 healthy controls. CKD patients were further stratified into stage 1-2 (n = 40) and stage 3-5 (n = 48) subgroups. The Ultrasound viscoelastic parameters (Emean, Vmean) and MVUS grading were compared between groups. Combined diagnostic models were built using binary logistic regression (Enter method) conducted in SPSS 22.0 based on parameters with statistically significant intergroup differences. Receiver operating characteristic (ROC) curve analysis was performed.

RESULTS

Significant differences were observed between the CKD and control groups for Emean, Vmean, and MVUS grading (p < 0.001). When comparing CKD stage 1-2 group with stage 3-5 group, significant differences were found for Emean and MVUS grading (p < 0.001), whereas the difference for Vmean was not statistically significant (p = 0.059). ROC analysis indicated that the integrated model combining Emean, Vmean, and MVUS grading for distinguishing CKD from controls yielded an AUC of 0.873, with a sensitivity of 71.59% and specificity of 93.88%. For distinguishing stage 1-2 from stage 3-5 CKD, the model combining Emean and MVUS grading achieved an AUC of 0.921, with a sensitivity of 70.83% and specificity of 97.50%.

CONCLUSION

Ultrasound viscoelastic imaging combined with MVUS demonstrates high diagnostic value for CKD diagnosis and preliminary staging, showing clinical application prospects.