Erschienen in:
01.12.2013 | Pediatric
Acoustic radiation force impulse (ARFI) in the evaluation of the renal parenchymal stiffness in paediatric patients with vesicoureteral reflux: preliminary results
verfasst von:
Costanza Bruno, Giuliana Caliari, Marco Zaffanello, Milena Brugnara, Michele Zuffante, Mariangela Cecchetto, Salvatore Minniti, Alice Pedot, Giorgio Talamini, Roberto Pozzi-Mucelli
Erschienen in:
European Radiology
|
Ausgabe 12/2013
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Abstract
Objectives
To prospectively evaluate acoustic radiation force impulse (ARFI) imaging of the kidneys in children with and without chronic renal disease.
Methods
Twenty-eight children (age range 9–16 years) with primary or secondary vesicoureteral reflux (≥ grade III) underwent scintigraphy and ultrasound with ARFI. Kidneys were divided—according to scintigraphy—into “affected” and “contralateral”; the results were compared with 16 age-matched healthy subjects. An ARFI value, expressed as speed (m/s) of wave propagation through the tissue, was calculated for each kidney through the mean of the values obtained at the upper, middle and lower third. The Wilcoxon test was used; P values <0.05 were considered statistically significant.
Results
The mean ARFI values obtained in the “affected” kidneys (5.70 ± 1.71 m/s) were significantly higher than those measured in both “contralateral” (4.09 ± 0.97, P < 0.0001) and “healthy” kidneys (3.13 ± 0.09, P < 0.0001). The difference between values in the “contralateral” kidneys and “healthy” ones was significant (P < 0.0001). The “affected” kidneys with secondary reflux had mean ARFI values (6.59 ± 1.45) significantly higher than those with primary reflux (5.35 ± 1.72).
Conclusions
ARFI values decrease from kidneys with secondary vesicoureteral reflux to kidneys with primary reflux to unaffected kidneys contralateral to reflux to normal kidneys.
Key points
• Acoustic radiation force impulse (ARFI) can quantify tissue elasticity during ultrasound examinations.
• Kidneys are highly heterogeneous and difficult to evaluate with ARFI.
• Kidneys damaged by vesicoureteral reflux are stiffer than normal.
• ARFI can identify initial damage in macroscopically normal kidneys.