Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Arndt R, Schmidt S, Loddenkemper C, Grünbaum M, Zidek W, van der Giet M, Westhoff TH. Noninvasive evaluation of renal allograft fibrosis by transient elastography--a pilot study. Transpl Int 2010;23:871-7. [PMID: 20158692 DOI: 10.1111/j.1432-2277.2010.01057.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]

For:	Arndt R, Schmidt S, Loddenkemper C, Grünbaum M, Zidek W, van der Giet M, Westhoff TH. Noninvasive evaluation of renal allograft fibrosis by transient elastography--a pilot study. Transpl Int 2010;23:871-7. [PMID: 20158692 DOI: 10.1111/j.1432-2277.2010.01057.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]

Number

Cited by Other Article(s)

Lal H, Ruidas S, Prasad R, Singh A, Prasad N, Kaul A, Bhadauria DS, Kushwaha RS, Patel MR, Jain M, Yadav P. Role of multi-parametric ultrasonography for the assessment and monitoring of functional status of renal allografts with histopathological correlation. World J Radiol 2024;16:782-793. [PMID: 39801670 PMCID: PMC11718520 DOI: 10.4329/wjr.v16.i12.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 11/03/2024] [Accepted: 11/19/2024] [Indexed: 12/27/2024] Open

Abstract

BACKGROUND

The study focuses on the use of multi-parametric ultrasound [gray scale, color Doppler and shear wave elastography (SWE)] to differentiate stable renal allografts from acute graft dysfunction and to assess time-dependent changes in parenchymal stiffness, thereby assessing its use as an efficient monitoring tool for ongoing graft dysfunction. To date, biopsy is the gold standard for evaluation of acute graft dysfunction. However, because it is invasive, it carries certain risks and cannot be used for follow-up monitoring. SWE is a non-invasive imaging modality that identifies higher parenchymal stiffness values in cases of acute graft dysfunction compared to stable grafts.

AIM

To assess renal allograft parenchymal stiffness by SWE and to correlate its findings with functional status of the graft kidney.

METHODS

This prospective observational study included 71 renal allograft recipients. Multi-parametric ultrasound was performed on all patients, and biopsies were performed in cases of acute graft dysfunction. The study was performed for a period of 2 years at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, a tertiary care center in north India. Independent samples t-test was used to compare the means between two independent groups. Paired-samples t-test was used to test the change in mean value between baseline and follow-up observations.

RESULTS

Thirty-one patients had experienced acute graft dysfunction at least once, followed by recovery, but none of them had a history of chronic renal allograft injury. Mean baseline parenchymal stiffness in stable grafts and acute graft dysfunction were 30.21 + 2.03 kPa (3.17 + 0.11 m/s) and 31.07 + 2.88 kPa (3.22 + 0.15 m/s), respectively; however, these differences were not statistically significant (P = 0.305 and 0.252, respectively). There was a gradual decrease in SWE values during the first 3 postoperative months, followed by an increase in SWE values up to one-year post-transplantation. Patients with biopsy-confirmed graft dysfunction showed higher SWE values compared to those with a negative biopsy. However, receiver operating characteristic analysis failed to show statistically significant cut-off values to differentiate between the stable graft and acute graft dysfunction.

CONCLUSION

Acute graft dysfunction displays higher parenchymal stiffness values compared to stable grafts. Therefore, SWE may be useful in monitoring the functional status of allografts to predict any ongoing dysfunction.

Collapse

Ruidas S, Lal H, Prasad R, Sharma S, Agarwal S, Singh R, Prasad N, Patel MR, Kushwaha RS, Jain M. Role of Shear Wave Elastography for Assessment of Renal-Allograft Fibrosis and its Correlation With Histopathology. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024;43:1979-1992. [PMID: 39076034 DOI: 10.1002/jum.16532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/05/2024] [Accepted: 07/13/2024] [Indexed: 07/31/2024]

Jesrani AK, Faiq SM, Rashid R, Kalwar TA, Mohsin R, Aziz T, Khan NA, Mubarak M. Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction. World J Transplant 2024;14:89255. [PMID: 38576755 PMCID: PMC10989465 DOI: 10.5500/wjt.v14.i1.89255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/15/2024] Open

Abstract

BACKGROUND

Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.

AIM

To compare the diagnostic performance of resistive index (RI) and shear wave elastography (SWE) in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.

METHODS

This is a cross-sectional and comparative study. A total of 154 kidney transplant recipients were included in this study, which was conducted at the Departments of Transplantation and Radiology, Sindh Institute of Urology and Transplan tation, Karachi, Pakistan, from August 2022 to February 2023. All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate (GFR) after three months of transplantation were enrolled in this study. SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.

RESULTS

The mean age of all patients was 35.32 ± 11.08 years. Among these, 126 (81.8%) were males and 28 (18.2%) were females. The mean serum creatinine in all patients was 2.86 ± 1.68 mg/dL and the mean estimated GFR was 35.38 ± 17.27 mL/min/1.73 m2. Kidney allograft biopsy results showed chronic changes in 55 (37.66%) biopsies. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE for the detection of chronic allograft damage were 93.10%, 96.87%%, 94.73%, and 95.87%, respectively, and the diagnostic accuracy was 95.45%. For RI, the sensitivity, specificity, PPV, and NPV were 76.92%, 83.33%, 70.17%, and 87.62%, respectively, and the diagnostic accuracy was 81.16%.

CONCLUSION

The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage. It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.

Collapse

Maralescu FM, Bende F, Sporea I, Popescu A, Sirli R, Schiller A, Petrica L, Miutescu B, Borlea A, Popa A, Bodea M, Bob F. Non-Invasive Evaluation of Kidney Elasticity and Viscosity in a Healthy Cohort. Biomedicines 2022;10:2859. [PMID: 36359379 PMCID: PMC9687569 DOI: 10.3390/biomedicines10112859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open

Abstract

Introduction: There is currently a lack of published data on kidney elasticity and viscosity. Non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE PLUS) and viscosity plane-wave ultrasound (Vi PLUS), have surfaced as new detection methods, which, thanks to efficient processing software, are expected to improve renal stiffness and viscosity measurements. This study aims to be the first one to assess the normal range values in normal renal function subjects and to investigate the factors that impact them. Methods: We conducted a cross-sectional study employing 50 participants (29 women and 21 men) with a mean age of 42.22 ± 13.17, a mean estimated glomerular filtration rate (eGFR) of 97.12 ± 11 mL/min/1.73 m2, a mean kidney length of 10.16 ± 0.66 cm, and a mean body mass index (BMI) of 24.24 ± 3.98. With a C6-1X convex transducer and the Ultra-FastTM software available on the Hologic Aixplorer Mach 30 ultrasound system, we acquired five measurements of renal cortical stiffness and viscosity (achieved from five distinct images in the middle part of the subcapsular cortex) from each kidney. The ten measurements’ median values correlated with the participant’s demographical, biological, and clinical parameters. Results: The mean kidney elasticity was 31.88 ± 2.89 kiloPascal (kPa), and the mean viscosity was 2.44 ± 0.57 Pascal.second (Pa.s) for a mean measurement depth 4.58 ± 1.02 cm. Renal stiffness seemed to be influenced by age (r = −0.7047, p < 0.0001), the measurement depth (r = −0.3776, p = 0.0075), and eGFR (r = 0.6101, p < 0.0001) but not by BMI (r = −0.2150, p = 0.1338), while viscosity appeared to be impacted by age (r = −0.4251, p = 0.0021), eGFR (r = 0.4057, p = 0.0038), the measurement depth (r = −0.4642, p = 0.0008), and BMI (r = −0.3676, p = 0.0086). The results of the one-way ANOVA used to test the differences in the variables among the three age sub-groups are statistically significant for both 2D-SWE PLUS (p < 0.001) and Vi PLUS (p = 0.015). The method found good intra-operator reproducibility for the 2D-SWE PLUS measurements, with an ICC of 0.8365 and a 95% CI of 0.7512 to 0.8990, and for the Vi PLUS measurements, with an ICC of 0.9 and a 95% CI of 0.8515 to 0.9397. Conclusions: Renal stiffness and viscosity screening may become an efficacious, low-cost way to gather supplemental diagnostic data from patients with chronic kidney disease (CKD). The findings demonstrate that these non-invasive methods are highly feasible and not influenced by gender and that their values correlate with renal function and decrease with age progression. Nevertheless, more research is required to ascertain their place in clinical practice.

Collapse

Affiliation(s)

Felix-Mihai Maralescu Division of Nephrology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Felix Bende Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Ioan Sporea Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Alina Popescu Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Roxana Sirli Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Adalbert Schiller Division of Nephrology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Ligia Petrica Division of Nephrology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Bogdan Miutescu Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Andreea Borlea Division of Endocrinology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
Alexandru Popa Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Madalina Bodea Division of Nephrology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Flaviu Bob Division of Nephrology, Department of Internal Medicine II, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania

Collapse

Maralescu FM, Bende F, Sporea I, Popescu A, Șirli R, Schiller A, Petrica L, Moga TV, Mare R, Grosu I, Bob F. Assessment of Renal Allograft Stiffness and Viscosity Using 2D SWE PLUS and Vi PLUS Measures-A Pilot Study. J Clin Med 2022;11:4370. [PMID: 35955985 PMCID: PMC9369292 DOI: 10.3390/jcm11154370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open

Abstract

Elastography is a useful noninvasive tool for the assessment of renal transplant recipients. 2D-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) have emerged as novel techniques that promise to offer improved renal stiffness and viscosity measures due to improved processing algorithms. Methods: We performed a cross-sectional study of 50 kidney transplanted patients (16 women, 34 men; mean age of 47.5 ± 12.5; mean estimated glomerular filtration rate (eGFR) estimated by Chronic Kidney Disease Epidemiology Collaboration formula: 52.19 ± 22.6 mL/min/1.73 m2; and a mean duration after transplant of 10.09 ± 5 years). For every patient, we obtained five valid measurements of renal stiffness (obtained from five different frames in the cortex of the renal graft), and also tissue viscosity, with a C6-1X convex transducer using the Ultra-Fast™ software available on the Aixplorer Mach 30 ultrasound system (Supersonic Imagine, Aix-en-Provence, France). The median values of elastographic and viscosity measures have been correlated with the patients’ demographic, biological, and clinical parameters. Results: We obtained a cut-off value of renal cortical stiffness of <27.3 kiloPascal(kPa) for detection of eGFR < 60 mL/min/1.73 m2 with 80% sensitivity and 85% specificity (AUC = 0.811, p < 0.0001), a cut-off value of <26.9 kPa for detection of eGFR < 45 mL/min/1.73 m2 with 82.6% sensitivity and 74% specificity (AUC = 0.789, p < 0.0001), and a cut-off value of <23 kPa for detection of eGFR < 30 mL/min/1.73 m2 with 88.8% sensitivity and 75.6% specificity (AUC = 0.852, p < 0.0001). We found a positive correlation coefficient between eGFR and the median measure of renal cortical stiffness (r = 0.5699, p < 0.0001), between eGFR the median measure of viscosity (r = 0.3335, p = 0.0180), between median depth of measures and renal cortical stiffness (r = −0.2795, p = 0.0493), and between median depth of measures and body mass index (BMI) (r = 0.6574, p < 0.0001). Our study showed good intra-operator agreement for both 2D SWE PLUS measures—with an intraclass correlation coefficient (ICC) of 0.9548 and a 95% CI of 0.9315 to 0.9719—and Vi PLUS, with an ICC of 0.8323 and a 95% CI of 0.7457 to 0.8959. The multivariate regression model showed that 2D SWE PLUS values were associated with eGFR, Vi PLUS, and depth of measures. Conclusions: Assessment of renal allograft stiffness and viscosity may prove to be an effective method for identifying patients with chronic allograft injury and could prove to be a low-cost approach to provide additional diagnostic information of kidney transplanted patients.

Collapse

Affiliation(s)

Felix-Mihai Maralescu Department of Internal Medicine II-Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania; (F.-M.M.); (A.S.); (L.P.); (I.G.); (F.B.) Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania
Felix Bende Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Ioan Sporea Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Alina Popescu Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Roxana Șirli Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Adalbert Schiller Department of Internal Medicine II-Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania; (F.-M.M.); (A.S.); (L.P.); (I.G.); (F.B.) Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania
Ligia Petrica Department of Internal Medicine II-Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania; (F.-M.M.); (A.S.); (L.P.); (I.G.); (F.B.) Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania
Tudor Voicu Moga Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Ruxandra Mare Department of Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.S.); (A.P.); (R.Ș.); (T.V.M.); (R.M.) Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes,” University of Medicine and Pharmacy, 30041 Timișoara, Romania
Iulia Grosu Department of Internal Medicine II-Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania; (F.-M.M.); (A.S.); (L.P.); (I.G.); (F.B.) Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania
Flaviu Bob Department of Internal Medicine II-Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania; (F.-M.M.); (A.S.); (L.P.); (I.G.); (F.B.) Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, EftimieMurgu Sq. No. 2, 300041 Timișoara, Romania

Collapse

Are the Currently Available Elastography Methods Useful in the Assessment of Chronic Kidney Disease? A Systematic Review and a Meta-Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052359] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]

Abstract Background: We require an quantitative imaging technique for the diagnosis and assessment of chronic kidney disease (CKD). Renal elastography has been widely used in recent years in different studies; however, the results across them are not consistent and, as a result, we conducted a meta-analysis of the published literature on this topic. Methods: The databases of PubMed, Medscape, Medline were searched for all studies published in English from 2010 until November 2021 that evaluated kidney shear wave speed (SWS) by elastography in patients with CKD. Trial design, methodological information, patient characteristics, interventions, results, and outcome data were all collected from each study according to a set protocol. Results: We found 37 publications, yet only 18 studies that utilized point shear wave elastography (Virtual Touch Quantification—VTQ system) were compared because the values achieved using different types of elastography are not evaluable. Finally, 1995 attendees (1241 patients with CKD versus 781 healthy subjects as the control group) were included. When comparing mean values of kidney SWS between studies we found increased heterogeneity Q = 513.133; DF = 10; p < 0001, I2 (inconsistency) = 98.12% (95% CI for I2 97.52–98.57%). With a standardized mean difference of −0.216, patients with CKD have a lower kidney SWS than healthy controls. A positive association between kidney SWS and eGFR was also discovered across the presented studies, with a pooled correlation coefficient of 0.38 (Z = 10.3, p < 0.001), Q = 73.3, DF = 5, p < 000.1, I2 = 93.18% (95% CI for I2 87.86 to 96.18). The pooled area under the ROC curve for kidney SWS to predict chronic kidney disease was 0.831 (95% CI, p < 0.001), Q = 28.32, DF = 6, p = 0.0001, I2 = 78.8% (95% CI for I2 56.37 to 89.72). In the four articles that used the Elast-PQ method, the data presented were insufficient for statistical analysis: area under the curve (AUC) values are used to compare distinct characteristics (differentiating kidney SWS between mildly and moderately impaired kidneys, between non-diabetic/prediabetic/diabetic patients, or kidney SWS between the CKD and control group), therefore not being suitable for further evaluation. Conclusions: The results show that patients with CKD have a lower kidney SWS than healthy controls. However, the number of studies involving renal elastography that have been published is limited and show an increased heterogeneity. Further research is needed to determine which factors actually influence kidney SWS in CKD patients and, as a result, to specify the role and indication of renal elastography in clinical practice. Collapse

Technical feasibility and correlations between shear-wave elastography and histology in kidney fibrosis in children. Pediatr Radiol 2021;51:1879-1888. [PMID: 33893848 DOI: 10.1007/s00247-021-05068-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/18/2020] [Accepted: 03/21/2021] [Indexed: 12/17/2022]

Fang JX, Chen XY, Yang QM, Xue MH. Factors Influencing Renal Parenchymal Stiffiness in Patients with Diabetic Nephropathy. Int J Gen Med 2021;14:1911-1917. [PMID: 34040423 PMCID: PMC8140885 DOI: 10.2147/ijgm.s311420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/29/2021] [Indexed: 11/23/2022] Open

Elastography: a surrogate marker of renal allograft fibrosis - quantification by shear-wave technique. Pol J Radiol 2021;86:e151-e156. [PMID: 33828625 PMCID: PMC8018265 DOI: 10.5114/pjr.2021.104582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022] Open

Turgutalp K, Balcı Y, Özer C, Bardak S, Gürses İ, Karabulut Y, Helvacı İ, Dölarslan E, Demir S, Kıykım A. Shear wave elastography findings in Immunoglobulin A Nephropathy patients: is it more specific and sensitive for interstitial fibrosis or interstitial fibrosis/tubular atrophy? Ren Fail 2021;42:590-599. [PMID: 32597278 PMCID: PMC7946010 DOI: 10.1080/0886022x.2020.1779087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open

Lee A, Joo DJ, Han WK, Jeong HJ, Oh MJ, Kim YS, Oh YT. Renal tissue elasticity by acoustic radiation force impulse: A prospective study of healthy kidney donors. Medicine (Baltimore) 2021;100:e23561. [PMID: 33545931 PMCID: PMC7837974 DOI: 10.1097/md.0000000000023561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/05/2020] [Indexed: 11/26/2022] Open

Lin YC, Wang JC, Wu MS, Lin YF, Chen CR, Chen CY, Chen KC, Peng CC. Nifedipine Exacerbates Lipogenesis in the Kidney via KIM-1, CD36, and SREBP Upregulation: Implications from an Animal Model for Human Study. Int J Mol Sci 2020;21:ijms21124359. [PMID: 32575412 PMCID: PMC7352626 DOI: 10.3390/ijms21124359] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/15/2022] Open

Affiliation(s)

Yen-Chung Lin Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (M.-S.W.); (Y.-F.L.) TMU-Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan
Jhih-Cheng Wang Division of Urology, Department of Surgery, Chi-Mei Medical Center, Tainan City 71004, Taiwan; Department of Electric Engineering, Southern Taiwan University of Science and Technology, Tainan City 71005, Taiwan
Mai-Szu Wu Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (M.-S.W.); (Y.-F.L.) TMU-Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan
Yuh-Feng Lin Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (M.-S.W.); (Y.-F.L.) TMU-Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan
Chang-Rong Chen International Medical Doctor Program, Vita-Salute San Raffaele University, 20132 Milan, Italy;
Chang-Yu Chen Program of Biomedical Sciences, College of Arts and Sciences, California Baptist University, Riverside, CA 92504, USA;
Kuan-Chou Chen Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; TMU-Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan Department of Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan Correspondence: (K.-C.C.); (C.-C.P.); Tel.: +886-02-22490088 (K.-C.C.); +886-02-27361661 (C.-C.P.)
Chiung-Chi Peng Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Correspondence: (K.-C.C.); (C.-C.P.); Tel.: +886-02-22490088 (K.-C.C.); +886-02-27361661 (C.-C.P.)

Collapse

Brown RS, Sun MRM, Stillman IE, Russell TL, Rosas SE, Wei JL. The utility of magnetic resonance imaging for noninvasive evaluation of diabetic nephropathy. Nephrol Dial Transplant 2020;35:970-978. [PMID: 31329940 PMCID: PMC7282829 DOI: 10.1093/ndt/gfz066] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/13/2019] [Indexed: 12/18/2022] Open

Abstract

BACKGROUND

Noninvasive quantitative measurement of fibrosis in chronic kidney disease (CKD) would be desirable diagnostically and therapeutically but standard radiologic imaging is too variable for clinical usage. By applying a vibratory force, tissue shear wave stiffness can be measured by magnetic resonance elastography (MRE) that may correlate with progression of kidney fibrosis. Since decreased kidney perfusion decreases tissue turgor and stiffness, we combined newly available three-dimensional MRE shear stiffness measurements with MR arterial spin labeling (ASL) kidney blood flow rates to evaluate fibrosis in diabetic nephropathy.

METHODS

Thirty individuals with diabetes and Stage 0-5 CKD and 13 control individuals without CKD underwent noncontrast MRE with concurrent ASL blood flow measurements.

RESULTS

MRE cortical shear stiffness at 90 Hz was decreased significantly below controls in all CKD stages of diabetic nephropathy. Likewise, ASL blood flow decreased progressively from 480 ± 136 mL/min/100 g of cortical tissue in controls to 302 ± 95, 229 ± 7 and 152 ± 32 mL/min/100 g in Stages 3, 4 and 5 CKD, respectively. A magnetic resonance imaging (MRI) surrogate for the measured glomerular filtration fraction [surrogate filtration fraction = estimated glomerular filtration rate (eGFR)/ASL] decreased progressively from 0.21 ± 0.07 in controls to 0.16 ± 0.04 in Stage 3 and 0.10 ± 0.02 in Stage 4-5 CKD.

CONCLUSIONS

In this pilot study, MRI with ASL blood flow rates can noninvasively measure decreasing kidney cortical tissue perfusion and, with eGFR, a decreasing surrogate filtration fraction in worsening diabetic nephropathy that appears to correlate with increasing fibrosis. Differing from the liver, MRE shear stiffness surprisingly decreases with worsening CKD, likely related to decreased tissue turgor from lower blood flow rates.

Collapse

Kennedy P, Bane O, Hectors SJ, Gordic S, Berger M, Delaney V, Salem F, Lewis S, Menon M, Taouli B. Magnetic resonance elastography vs. point shear wave ultrasound elastography for the assessment of renal allograft dysfunction. Eur J Radiol 2020;126:108949. [PMID: 32179424 PMCID: PMC7210723 DOI: 10.1016/j.ejrad.2020.108949] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]

Abstract

PURPOSE

To investigate the utility of magnetic resonance elastography (MRE) vs. ultrasound (US) point shear wave elastography (pSWE) for the assessment of chronic renal allograft dysfunction, prediction of outcome and determine the correlation with Banff pathology scores.

METHODS

In this IRB approved prospective study, 27 enrolled patients with functional (n = 15) and chronic dysfunctional (n = 12) renal allografts underwent same day 2D MRE and pSWE. Histogram parameters [including mean, median, standard deviation, kurtosis and skewness] of the magnitude of the complex shear modulus (MRE) and median Young's modulus (pSWE) were measured in the cortex (MRE and pSWE) and combined corticomedullary regions (MRE). Histopathology was available for 16 patients (4 functional, 12 dysfunctional).

RESULTS

MRE and pSWE stiffness were not significantly different between functional and dysfunctional groups (p range 0.139-0.347). The skewness of MRE corticomedullary stiffness was significantly lower (p = 0.04) in patients with chronic dysfunction and correlated significantly with Banff histopathologic scores (range r=-0.518-0.567, p = 0.035-0.040). MRE cortical and corticomedullary mean stiffness showed strong performance in predicting graft loss/relist (AUC 0.958, p = 0.011 for both). Reliable pSWE measurements were obtained in 13 patients (48 %). pSWE stiffness did not correlate with Banff scores and did not predict outcome.

CONCLUSIONS

The skewness of MRE corticomedullary stiffness is sensitive to changes in chronic allograft dysfunction, while mean/median MRE renal stiffness and median US stiffness did not differentiate patients with stable function vs those with chronic renal allograft dysfunction. MRE corticomedullary mean stiffness appears to be a predictor of graft loss/relist. pSWE was not found to be a useful method for assessing renal allografts.

Collapse

Bolboacă SD, Elec FI, Elec AD, Muntean AM, Socaciu MA, Iacob G, Zaro R, Andrieș AI, Bădulescu RM, Ignat RM, Iancu M, Badea RI. Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study. Diagnostics (Basel) 2020;10:E41. [PMID: 31941112 PMCID: PMC7169400 DOI: 10.3390/diagnostics10010041] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/30/2019] [Accepted: 01/10/2020] [Indexed: 12/12/2022] Open

Abstract

Shear-wave elastography (SWE) showed the absence or presence of significant differences among stable kidney allograft function and allograft dysfunction. We evaluated the variability of kidney allograft stiffness in relation to allograft dysfunction, respectively, in terms of a correlation of stiffness with patients' characteristics. A single-center prospective study on patients who had undergone renal transplantation was conducted between October 2017 and November 2018. Patients were clinically classified as having a stable allograft function or allograft dysfunction. SWE examinations performed by the same radiologist with a LOGIQ E9 were evaluated. Ten measurements were done for Young's modulus (kPa) at the level of allograft cortex and another ten at the level of medulla. Eighty-three SWE examinations from 63 patients, 69 stable allografts, and 14 allografts with dysfunction were included in the analysis. The intra-examinations stiffness showed high variability, with the quantile covariation coefficient ranging from 2.21% to 45.04%. The inter-examinations stiffness showed heterogeneity (from 28.66% to 42.38%). The kidney allograft cortex stiffness showed significantly higher values in cases with dysfunction (median = 28.70 kPa, interquartile range (IQR) = (25.68-31.98) kPa) as compared to those with stable function (median = 20.99 kPa, interquartile range = (16.08-27.68) kPa; p-value = 0.0142). Allograft tissue stiffness (both cortex and medulla) was significantly negatively correlated with body mass index (-0.44, p-value < 0.0001 for allograft cortex and -0.42, p-value = 0.0001 for allograft medulla), and positively correlated with Proteinuria/Creatinuria ratio (0.33, p-value = 0.0021 for allograft cortex and 0.28, p-value = 0.0105 for allograft medulla) but remained statistically significant only in cases with stable function. The cortical tissue stiffness proved significantly higher values for patients with allograft dysfunction as compared to patients with stable function, but to evolve as an additional tool for the evaluation of patients with a kidney transplant and to change the clinical practice, more extensive studies are needed.

Collapse

Affiliation(s)

Sorana D. Bolboacă Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
Florin Ioan Elec Department of Urology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania; Department of Renal Transplantation, Clinical Institute of Urology and Renal Transplantation, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania; (A.D.E.); (A.M.M.); (G.I.)
Alina Daciana Elec Department of Renal Transplantation, Clinical Institute of Urology and Renal Transplantation, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania; (A.D.E.); (A.M.M.); (G.I.)
Adriana Milena Muntean Department of Renal Transplantation, Clinical Institute of Urology and Renal Transplantation, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania; (A.D.E.); (A.M.M.); (G.I.)
Mihai Adrian Socaciu Department of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Croitorilor Str., no. 19-23, 400162 Cluj-Napoca, Romania; (M.A.S.); (R.Z.) Department of Medical Imaging, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Constanța Str., no. 5, 400162 Cluj-Napoca, Romania
Gheorghita Iacob Department of Renal Transplantation, Clinical Institute of Urology and Renal Transplantation, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania; (A.D.E.); (A.M.M.); (G.I.)
Răzvan Zaro Department of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Croitorilor Str., no. 19-23, 400162 Cluj-Napoca, Romania; (M.A.S.); (R.Z.) Department of Medical Imaging, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Constanța Str., no. 5, 400162 Cluj-Napoca, Romania
Alexandra-Ioana Andrieș Department of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Croitorilor Str., no. 19-23, 400162 Cluj-Napoca, Romania; (M.A.S.); (R.Z.) Department of Medical Imaging, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Constanța Str., no. 5, 400162 Cluj-Napoca, Romania
Ramona Maria Bădulescu Department of Urology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor Str., no. 4-6, 400006 Cluj-Napoca, Romania;
Radu Mihai Ignat Department of Anatomy, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor Str., no. 3-5, 400006 Cluj-Napoca, Romania;
Mihaela Iancu Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
Radu Ion Badea Department of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Croitorilor Str., no. 19-23, 400162 Cluj-Napoca, Romania; (M.A.S.); (R.Z.) Department of Medical Imaging, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Constanța Str., no. 5, 400162 Cluj-Napoca, Romania

Collapse

Jiang K, Ferguson CM, Lerman LO. Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques. Transl Res 2019;209:105-120. [PMID: 31082371 PMCID: PMC6553637 DOI: 10.1016/j.trsl.2019.02.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/12/2019] [Accepted: 02/20/2019] [Indexed: 02/06/2023]

Increased renal cortical stiffness obtained by share-wave elastography imaging significantly predicts the contrast-induced nephropathy in patients with preserved renal function. J Ultrasound 2019;22:185-191. [PMID: 30877661 DOI: 10.1007/s40477-019-00373-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/06/2019] [Indexed: 01/16/2023] Open

Hossain MM, Detwiler RK, Chang EH, Caughey MC, Fisher MW, Nichols TC, Merricks EP, Raymer RA, Whitford M, Bellinger DA, Wimsey LE, Gallippi CM. Mechanical Anisotropy Assessment in Kidney Cortex Using ARFI Peak Displacement: Preclinical Validation and Pilot In Vivo Clinical Results in Kidney Allografts. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019;66:551-562. [PMID: 30106723 PMCID: PMC8232042 DOI: 10.1109/tuffc.2018.2865203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]

Abstract

The kidney is an anisotropic organ, with higher elasticity along versus across nephrons. The degree of mechanical anisotropy in the kidney may be diagnostically relevant if properly exploited; however, if improperly controlled, anisotropy may confound stiffness measurements. The purpose of this study is to demonstrate the clinical feasibility of acoustic radiation force (ARF)-induced peak displacement (PD) measures for both exploiting and obviating mechanical anisotropy in the cortex of human kidney allografts, in vivo. Validation of the imaging methods is provided by preclinical studies in pig kidneys, in which ARF-induced PD values were significantly higher ( , Wilcoxon) when the transducer executing asymmetric ARF was oriented across versus along the nephrons. The ratio of these PD values obtained with the transducer oriented across versus along the nephrons strongly linearly correlated ( R2 = 0.95 ) to the ratio of shear moduli measured by shear wave elasticity imaging. On the contrary, when a symmetric ARF was implemented, no significant difference in PD was observed ( p > 0.01 ). Similar results were demonstrated in vivo in the kidney allografts of 14 patients. The symmetric ARF produced PD measures with no significant difference ( p > 0.01 ) between along versus across alignments, but the asymmetric ARF yielded PD ratios that remained constant over a six-month observation period post-transplantation, consistent with stable serum creatinine level and urine protein-to-creatinine ratio in the same patient population ( p > 0.01 ). The results of this pilot in vivo clinical study suggest the feasibility of 1) implementing symmetrical ARF to obviate mechanical anisotropy in the kidney cortex when anisotropy is a confounding factor and 2) implementing asymmetric ARF to exploit mechanical anisotropy when mechanical anisotropy is a potentially relevant biomarker.

Collapse

Urban M. Current and Future Clinical Applications of Elasticity Imaging Techniques. ULTRASOUND ELASTOGRAPHY FOR BIOMEDICAL APPLICATIONS AND MEDICINE 2018:471-491. [DOI: 10.1002/9781119021520.ch30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]

Koc AS, Sumbul HE. Renal cortical stiffness obtained by shear wave elastography imaging is increased in patients with type 2 diabetes mellitus without diabetic nephropathy. J Ultrasound 2018;21:279-285. [PMID: 30051234 DOI: 10.1007/s40477-018-0315-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/18/2018] [Indexed: 12/31/2022] Open

Abstract

PURPOSE

It is known that patients with type 2 diabetes mellitus (DM) who develop diabetic nephropathy have increased renal cortical stiffness (CS) determined by shear wave elastography (SWE). However, there is no data in the literature to our knowledge related to CS values determined by SWE in type 2 DM patients with normal renal function. In this study, we aimed to investigate the change of renal CS obtained by SWE examination in type 2 DM patients with normal renal function compared to non DM patients.

METHODS

A total of 103 patients (86 males, 17 females and mean age 63.2 ± 11.8 years) with or without type 2 DM were included in the study. The eGFR value of all patients was > 60 ml/kg/1.73². Routine history, physical examination and laboratory examinations were performed. In addition to routine renal ultrasonography (USG), renal resistive index (RRI), renal pulsatility index (RPI), accelerated time (AT), and CS were measured.

RESULTS

Fifty patients with type 2 DM and 53 patients without type 2 DM were included in the study. Patients with type 2 DM had higher blood glucose, blood urea nitrogen and HbA1c levels (p < 0.05 each one). Renal length and width and echogenicity were similar between two groups with conventional renal USG. Renal parenchyma thickness was higher in patients with type 2 DM. When the findings of renal Doppler USG were examined, RRI was similar between two groups. RPI and AT were higher in patients with type 2 DM. CS values obtained with renal SWE were significantly higher in patients with type 2 DM (p < 0.05).

CONCLUSION

Cortical stiffness value obtained by SWE is significantly higher in type 2 DM patients with normal renal function compared to patients without DM. We recommend CS measurement as part of routine screening of nephropathy in patients with type 2 DM and normal renal function to guide management and treatment plan.

Collapse

Soudmand A, Ulu Ozturk F, Uslu N, Haberal N, Boyvat F, Moray G, Haberal M. Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients. EXP CLIN TRANSPLANT 2018;20:472-479. [PMID: 29993356 DOI: 10.6002/ect.2017.0238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]

Abstract

OBJECTIVES

Although biopsy is the most important method for diagnosing the cause of renal allograft dysfunction, sonoelastography, a new ultrasonography method, can be used to distinguish between the soft or hard nature of lesions. In this study, our aim was to investigate whether sonoelastography could diagnose fibrosis in renal transplant patients.

MATERIALS AND METHODS

In this prospective study, we included patients over 18 years old who were recommended for clinical biopsy. Sonoelastographic evaluation was made by conducting acoustic radiation force impulse measurements for each patient after they were admitted to the clinic for biopsy. Measurements were performed just before the biopsy procedure. All results were examined by 2 experienced radiologists using the Siemens S3000 Ultrasound Machine (Erlangen, Germany). Comparisons of ultrasonographic values with biopsy results were made with SPSS software (SPSS: An IBM Company, version 20, IBM Corporation, Armonk, NY, USA).

RESULTS

Of the 65 patients included in this study, pathology showed acute T-cell-mediated rejection in 37 patients. There was a significant correlation between the pathologic Banff scores and the sonographic acoustic radiation force impulse values (P = .002), where the degree of Banff increased as the mean acoustic radiation force impulse values elevated. A rise in mean impulse values correlated with increased degree of interstitial fibrosis in renal allografts. Renal parenchymal echogenicity of patients significantly differed by sex (P = .009), with an average renal echogenicity of grade 1 in women and grade 0 in men. Also, a statistically significant difference was found between age of the renal transplant recipient and resistive index values.

CONCLUSIONS

Our study showed a significant correlation between Banff degree and the acoustic radiation force impulse values of renal transplant patients. In addition to biopsy, sonoelastography can be beneficial for the diagnosis of fibrosis in renal transplant patients.

Collapse

Herrera J, Henke CA, Bitterman PB. Extracellular matrix as a driver of progressive fibrosis. J Clin Invest 2018;128:45-53. [PMID: 29293088 DOI: 10.1172/jci93557] [Citation(s) in RCA: 416] [Impact Index Per Article: 59.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open

Zhao SQ, Xue ZZ, Wang LZ. HMGB1, TGF-β and NF-κB are associated with chronic allograft nephropathy. Exp Ther Med 2017;14:6138-6146. [PMID: 29285170 DOI: 10.3892/etm.2017.5319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/03/2017] [Indexed: 12/18/2022] Open

Abstract

The present study aimed to investigate the association between high mobility group protein B1 (HMGB1), transforming growth factor-β1 (TGF-β1), nuclear factor-κB (NF-κB) and chronic allograft nephropathy (CAN) and to identify the clinical significance of HMGB1, TGF-β1, NF-κB on patients with CAN. Between September 2012 and November 2014, 27 patients with CAN diagnosed by biopsy were enrolled in the present study and a further 30 patients that underwent nephrectomy following trauma were selected as the control group. Immunohistochemical staining with HMGB1, TGF-β1 and NF-κB expression in the renal tissues, and western blot analysis were used to measure the relative expression of HMGB1, TGF-β1 and NF-κB. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to estimate the relative expression of HMGB1, TGF-β1 and NF-κB mRNA. Statistical analysis was used to calculate the association between HMGB1, TGF-β1 and NF-κB expression and CAN grade. Immunohistochemical staining demonstrated that HMGB1, TGF-β1 and NF-κB had markedly positive expression rates in renal tubular epithelial cell cytoplasm and membranes in CAN renal tissues, and the positive rates of HMGB1, TGF-β1 and NF-κB increased with the aggravation of CAN pathological grade (I, II and III). The results of western blot analysis indicated that the expression levels of HMGB1, TGF-β1 and NF-κB were significantly higher in the CAN group, compared with the normal group (P<0.05), and the expression levels increased with the progression of CAN grade. A positive association among HMGB1, TGF-β1 and NF-κB expression was identified. RT-qPCR analysis demonstrated that the expression of HMGB1, TGF-β1 and NF-κB mRNA in the CAN group was significantly higher than in the normal group (P<0.05), and the relative expression level of HMGB1, TGF-β1 and NF-κB mRNA not only increased with the aggravation of CAN grade, but was also positively associated with the expression of HMGB1, TGF-β1 and NF-κB, respectively. The abnormal expression of HMGB1, TGF-β1 and NF-κB is therefore, an important manifestation of CAN and the expression of HMGB1, TGF-β1 and NF-κB mRNA in the renal tissues are significantly associated with CAN pathological progression. HMGB1, TGF-β1 and NF-κB may form a signaling pathway that leads to the occurrence of CAN, which induces renal interstitial fibrosis.

Collapse

Marticorena Garcia SR, Grossmann M, Lang ST, Tzschätzsch H, Dittmann F, Hamm B, Braun J, Guo J, Sack I. Tomoelastography of the native kidney: Regional variation and physiological effects on in vivo renal stiffness. Magn Reson Med 2017;79:2126-2134. [DOI: 10.1002/mrm.26892] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/17/2017] [Accepted: 08/08/2017] [Indexed: 12/21/2022]

Association of Renal Elasticity and Renal Function Progression in Patients with Chronic Kidney Disease Evaluated by Real-Time Ultrasound Elastography. Sci Rep 2017;7:43303. [PMID: 28240304 PMCID: PMC5327389 DOI: 10.1038/srep43303] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022] Open

Hassan K, Loberant N, Abbas N, Fadi H, Shadia H, Khazim K. Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease. Ther Clin Risk Manag 2016;12:1615-1622. [PMID: 27853373 PMCID: PMC5106220 DOI: 10.2147/tcrm.s118465] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open

Abstract

Objective

The assessment of the grade of renal fibrosis in diabetic kidney disease (DKD) requires renal biopsy, which may be associated with certain risks. To assess the severity of chronic pathologic changes in DKD, we performed a quantitative analysis of renal parenchymal stiffness in advanced DKD, using shear wave elastography (SWE) imaging.

Patients and methods

Twenty-nine diabetic patients with chronic kidney disease (CKD) grades 3–4 due to DKD, and 23 healthy subjects were enrolled. Combined conventional ultrasound and SWE imaging were performed on all participants. The length, width, and cortical thickness and stiffness were recorded for each kidney.

Results

Cortical thickness was lower in patients with DKD than in healthy subjects (13.8±2.2 vs 14.8±1.6 mm; P=0.002) and in DKD patients with CKD grade 4 than in those with grade 3 (13.0±3.5 vs 14.7±2.1 mm; P<0.001). Cortical stiffness was greater in patients with DKD than in healthy subjects (23.72±14.33 vs 9.02±2.42 kPa; P<0.001), in DKD patients with CKD grade 4 than in those with grade 3 (30.4±16.2 vs 14.6±8.1 kPa; P<0.001), and in DKD patients with CKD grade 3b, than in those with CKD grade 3a (15.7±6.7 vs 11.0±4.2 kPa; P=0.03). Daily proteinuria was higher in DKD patients with CKD grade 4 than in those with grade 3 (5.52±0.96 vs 1.13±0.72; P=0.001), and in DKD patients with CKD grade 3b, than in those with CKD grade 3a (1.59±0.59 vs 0.77±0.48; P<0.001). Cortical stiffness was inversely correlated with the estimated glomerular filtration rate (r=−0.65, P<0.001) and with cortical thickness (r=−0.43, P<0.001) in patients with DKD.

Conclusions

In patients with advanced DKD, SWE imaging may be utilized as a simple and practical method for quantitative evaluation of the chronic morphological changes and for the differentiation between CKD grades.

Collapse

Bruno C, Minniti S, Bucci A, Pozzi Mucelli R. ARFI: from basic principles to clinical applications in diffuse chronic disease-a review. Insights Imaging 2016;7:735-46. [PMID: 27553006 PMCID: PMC5028343 DOI: 10.1007/s13244-016-0514-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 07/05/2016] [Accepted: 07/19/2016] [Indexed: 12/11/2022] Open

Szeto SG, Narimatsu M, Lu M, He X, Sidiqi AM, Tolosa MF, Chan L, De Freitas K, Bialik JF, Majumder S, Boo S, Hinz B, Dan Q, Advani A, John R, Wrana JL, Kapus A, Yuen DA. YAP/TAZ Are Mechanoregulators of TGF-β-Smad Signaling and Renal Fibrogenesis. J Am Soc Nephrol 2016;27:3117-3128. [PMID: 26961347 DOI: 10.1681/asn.2015050499] [Citation(s) in RCA: 340] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 02/02/2016] [Indexed: 11/03/2022] Open

Affiliation(s)

Stephen G Szeto Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.,Institute of Medical Science and
Masahiro Narimatsu Center for Systems Biology, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital and Department of Molecular Genetics
Mingliang Lu Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Xiaolin He Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Ahmad M Sidiqi Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.,Institute of Medical Science and
Monica F Tolosa Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.,Department of Laboratory Medicine and Pathobiology, School of Graduate Studies
Lauren Chan Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Krystale De Freitas Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Janne Folke Bialik Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Syamantak Majumder Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Stellar Boo Laboratory of Tissue Repair and Regeneration, Matrix Dynamics Group, Faculty of Dentistry, and
Boris Hinz Laboratory of Tissue Repair and Regeneration, Matrix Dynamics Group, Faculty of Dentistry, and
Qinghong Dan Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
Andrew Advani Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.,Institute of Medical Science and
Rohan John Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Ontario, Canada
Jeffrey L Wrana Center for Systems Biology, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital and Department of Molecular Genetics
Andras Kapus Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.,Institute of Medical Science and
Darren A Yuen Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and .,Institute of Medical Science and.,Department of Laboratory Medicine and Pathobiology, School of Graduate Studies

Collapse

Samir AE, Allegretti AS, Zhu Q, Dhyani M, Anvari A, Sullivan DA, Trottier CA, Dougherty S, Williams WW, Babitt JL, Wenger J, Thadhani RI, Lin HY. Shear wave elastography in chronic kidney disease: a pilot experience in native kidneys. BMC Nephrol 2015;16:119. [PMID: 26227484 PMCID: PMC4521488 DOI: 10.1186/s12882-015-0120-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 07/22/2015] [Indexed: 12/17/2022] Open

Lal A, Naranje P, Pavunesan SK. What's new in urologic ultrasound? Indian J Urol 2015;31:176-84. [PMID: 26166960 PMCID: PMC4495491 DOI: 10.4103/0970-1591.159604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open

Low G, Owen NE, Joubert I, Patterson AJ, Graves MJ, Alexander GJM, Lomas DJ. Magnetic resonance elastography in the detection of hepatorenal syndrome in patients with cirrhosis and ascites. Eur Radiol 2015;25:2851-8. [PMID: 25903705 DOI: 10.1007/s00330-015-3723-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 03/18/2015] [Accepted: 03/18/2015] [Indexed: 02/07/2023]

Bob F, Bota S, Sporea I, Sirli R, Petrica L, Schiller A. Kidney shear wave speed values in subjects with and without renal pathology and inter-operator reproducibility of acoustic radiation force impulse elastography (ARFI)--preliminary results. PLoS One 2014;9:e113761. [PMID: 25426849 PMCID: PMC4245225 DOI: 10.1371/journal.pone.0113761] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 10/29/2014] [Indexed: 12/18/2022] Open

Lukenda V, Mikolasevic I, Racki S, Jelic I, Stimac D, Orlic L. Transient elastography: a new noninvasive diagnostic tool for assessment of chronic allograft nephropathy. Int Urol Nephrol 2014;46:1435-1440. [PMID: 24966148 DOI: 10.1007/s11255-014-0697-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/18/2014] [Indexed: 01/05/2023]

Wang L, Xia P, Lv K, Han J, Dai Q, Li XM, Chen LM, Jiang YX. Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease. Eur Radiol 2014;24:1694-9. [PMID: 24744199 DOI: 10.1007/s00330-014-3162-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/21/2014] [Indexed: 01/01/2023]

Kahn J, Slowinski T, Thomas A, Filimonow S, Fischer T. TSI ultrasound elastography for the diagnosis of chronic allograft nephropathy in kidney transplanted patients. J Ultrason 2013;13:253-62. [PMID: 26674928 PMCID: PMC4603225 DOI: 10.15557/jou.2013.0027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/09/2013] [Accepted: 08/16/2013] [Indexed: 01/20/2023] Open

Lee CU, Glockner JF, Glaser KJ, Yin M, Chen J, Kawashima A, Kim B, Kremers WK, Ehman RL, Gloor JM. MR elastography in renal transplant patients and correlation with renal allograft biopsy: a feasibility study. Acad Radiol 2012;19:834-41. [PMID: 22503893 DOI: 10.1016/j.acra.2012.03.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 03/03/2012] [Accepted: 03/04/2012] [Indexed: 12/22/2022]

Tissue elasticity estimated by acoustic radiation force impulse quantification depends on the applied transducer force: an experimental study in kidney transplant patients. Eur Radiol 2012;22:2130-7. [PMID: 22610533 DOI: 10.1007/s00330-012-2476-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 03/16/2012] [Accepted: 03/22/2012] [Indexed: 02/08/2023]

Grenier N, Poulain S, Lepreux S, Gennisson JL, Dallaudière B, Lebras Y, Bavu E, Servais A, Meas-Yedid V, Piccoli M, Bachelet T, Tanter M, Merville P, Couzi L. Quantitative elastography of renal transplants using supersonic shear imaging: a pilot study. Eur Radiol 2012;22:2138-46. [PMID: 22588518 DOI: 10.1007/s00330-012-2471-9] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/12/2012] [Accepted: 03/16/2012] [Indexed: 12/13/2022]

Abstract

PURPOSE

To evaluate the reliability of quantitative ultrasonic measurement of renal allograft elasticity using supersonic shear imaging (SSI) and its relationship with parenchymal pathological changes.

MATERIALS AND METHODS

Forty-three kidney transplant recipients (22 women, 21 men) (mean age, 51 years; age range, 18-70 years) underwent SSI elastography, followed by biopsy. The quantitative measurements of cortical elasticity were performed by two radiologists and expressed in terms of Young's modulus (kPa). Intra- and inter-observer reproducibility was assessed (Kruskal-Wallis test and Bland-Altman analysis), as well as the correlation between elasticity values and clinical, biological and pathological data (semi-quantitative Banff scoring). Interstitial fibrosis was evaluated semi-quantitatively by the Banff score and measured by quantitative image analysis.

RESULTS

Intra- and inter-observer variation coefficients of cortical elasticity were 20 % and 12 %, respectively. Renal cortical stiffness did not correlate with any clinical parameters, any single semi-quantitative Banff score or the level of interstitial fibrosis; however, a significant correlation was observed between cortical stiffness and the total Banff scores of chronic lesions and of all elementary lesions (R = 0.34, P = 0.05 and R = 0.41, P = 0.03,respectively).

CONCLUSION

Quantitative measurement of renal cortical stiffness using SSI is a promising non-invasive tool to evaluate global histological deterioration.

KEY POINTS

• Supersonic shear imaging elastography can measure cortical stiffness in renal transplants • The level of cortical stiffness is correlated with the global degree of tissue lesions • The global histological deterioration of transplanted kidneys can be quantified using elastography.

Collapse

Amador C, Urban MW, Chen S, Greenleaf JF. Loss tangent and complex modulus estimated by acoustic radiation force creep and shear wave dispersion. Phys Med Biol 2012;57:1263-82. [PMID: 22345425 DOI: 10.1088/0031-9155/57/5/1263] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]

Amador C, Urban MW, Chen S, Greenleaf JF. Shearwave dispersion ultrasound vibrometry (SDUV) on swine kidney. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2011;58:2608-19. [PMID: 23443697 PMCID: PMC3588601 DOI: 10.1109/tuffc.2011.2124] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]

Abstract

Shearwave dispersion ultrasound vibrometry (SDUV) is used to quantify both tissue shear elasticity and shear viscosity by evaluating dispersion of shear wave propagation speed over a certain bandwidth (50 to 500 Hz). The motivation for developing elasticity imaging techniques is the desire to diagnose disease processes. However, it is important to study the mechanical properties of healthy tissues; such data can enhance clinical knowledge and improve understanding of the mechanical properties of tissue. The purpose of this study is to evaluate the feasibility of using SDUV for in vitro measurements of renal cortex shear elasticity and shear viscosity in healthy swine kidneys. Eight excised kidneys from female pigs were used in these in vitro experiments and a battery of tests was performed to gain insight into the material proper ties of the renal cortex. In these 8 kidneys, the overall renal cortex elasticity and viscosity were 1.81 ± 0.17 kPa and 1.48 ± 0.49 Pa-s, respectively. In an analysis of the material properties over time after excision, there was not a statistically significant difference in shear elasticity over a 24-h period, but a statistically significant difference in shear viscosity was found. Homogeneity of the renal cortex was examined and it was found that shear elasticity and shear viscosity were statistically different within a kidney, suggesting global tissue inhomogeneity. In creases of more than 30% in shear elasticity and shear viscosity were observed after immersion in 10% formaldehyde. Finally, it was found that the renal cortex is rather anisotropic. Two values for shear elasticity and shear viscosity were measured depending on shear wave propagation direction. These various tests elucidated different aspects of the material properties and the structure of the ex vivo renal cortex.

Collapse

Chung BH, Oh HJ, Piao SG, Sun IO, Kang SH, Choi SR, Park HS, Choi BS, Choi YJ, Park CW, Kim YS, Cho ML, Yang CW. Higher infiltration by Th17 cells compared with regulatory T cells is associated with severe acute T-cell-mediated graft rejection. Exp Mol Med 2011;43:630-7. [PMID: 21865860 PMCID: PMC3249589 DOI: 10.3858/emm.2011.43.11.071] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2011] [Indexed: 01/01/2023] Open

Sarvazyan A, Hall TJ, Urban MW, Fatemi M, Aglyamov SR, Garra BS. AN OVERVIEW OF ELASTOGRAPHY - AN EMERGING BRANCH OF MEDICAL IMAGING. Curr Med Imaging 2011;7:255-282. [PMID: 22308105 PMCID: PMC3269947 DOI: 10.2174/157340511798038684] [Citation(s) in RCA: 255] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]

Abstract

From times immemorial manual palpation served as a source of information on the state of soft tissues and allowed detection of various diseases accompanied by changes in tissue elasticity. During the last two decades, the ancient art of palpation gained new life due to numerous emerging elasticity imaging (EI) methods. Areas of applications of EI in medical diagnostics and treatment monitoring are steadily expanding. Elasticity imaging methods are emerging as commercial applications, a true testament to the progress and importance of the field.In this paper we present a brief history and theoretical basis of EI, describe various techniques of EI and, analyze their advantages and limitations, and overview main clinical applications. We present a classification of elasticity measurement and imaging techniques based on the methods used for generating a stress in the tissue (external mechanical force, internal ultrasound radiation force, or an internal endogenous force), and measurement of the tissue response. The measurement method can be performed using differing physical principles including magnetic resonance imaging (MRI), ultrasound imaging, X-ray imaging, optical and acoustic signals.Until recently, EI was largely a research method used by a few select institutions having the special equipment needed to perform the studies. Since 2005 however, increasing numbers of mainstream manufacturers have added EI to their ultrasound systems so that today the majority of manufacturers offer some sort of Elastography or tissue stiffness imaging on their clinical systems. Now it is safe to say that some sort of elasticity imaging may be performed on virtually all types of focal and diffuse disease. Most of the new applications are still in the early stages of research, but a few are becoming common applications in clinical practice.

Collapse

Rouvière O, Souchon R, Pagnoux G, Ménager JM, Chapelon JY. Magnetic resonance elastography of the kidneys: feasibility and reproducibility in young healthy adults. J Magn Reson Imaging 2011;34:880-6. [PMID: 21769970 PMCID: PMC3176985 DOI: 10.1002/jmri.22670] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 05/05/2011] [Indexed: 12/21/2022] Open

Derieppe M, Delmas Y, Gennisson JL, Deminière C, Placier S, Tanter M, Combe C, Grenier N. Detection of intrarenal microstructural changes with supersonic shear wave elastography in rats. Eur Radiol 2011;22:243-50. [PMID: 21845464 DOI: 10.1007/s00330-011-2229-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 07/25/2011] [Accepted: 07/28/2011] [Indexed: 11/26/2022]

Warner L, Yin M, Glaser KJ, Woollard JA, Carrascal CA, Korsmo MJ, Crane JA, Ehman RL, Lerman LO. Noninvasive In vivo assessment of renal tissue elasticity during graded renal ischemia using MR elastography. Invest Radiol 2011;46:509-14. [PMID: 21467945 PMCID: PMC3128234 DOI: 10.1097/rli.0b013e3182183a95] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]