PURPOSE: PURPOSE. To prospectively evaluate the tissue stiffness of the renal parenchyma in paediatric patients with chronic renal disease, by means of ARFI . METHOD AND MATERIALS: MATERIAL AND METHODS. 28 children (age range: 8 to 16 years) with vesicoureteral reflux (>/=grade III), either primary (18 cases) or due to obstruction (10 cases), underwent scintigraphy, blood analysis (cystatine C, creatinine, BUN) and ultrasound with ARFI. The results were compared with those obtained in 12 age-matched healthy controls who underwent blood analysis, ultrasound and ARFI. The results of ARFI examination were expressed as speed (m/sec) of wave propagation through tissues: the stiffer a tissue the faster the wave propagation. A global ARFI value was calculated for each kidney through the sum of the values (each of them resulting from the average of three different measurements) obtained at the upper, middle and lower third.The t-test per paired data was adopted. P values <0.05 were considered statistically significant. Pearson correlation coefficient was used to describe relationship between two variables. All data are reported as mean +/- standard deviation (confidence interval: 95%). RESULTS: RESULTS. The ARFI values obtained in the affected kidneys of the patients with renal disease (17.6+/-4.5 m/sec) were significantly higher than those measured in the controlateral unaffected kidney of the same patients (13.2+/-4.76 m/sec: p<0.017) and those measured in the kidneys of the healthy controls (9.3+/-0.18 m/sec): p<0.001). The difference between the ARFI values in the unaffected kidneys of the patients with renal disease (13.2+/-4.76 m/sec) and the kidneys of the healthy controls (9.3+/-0.18 m/sec) was statistically significant too (p<0.04). Among the affected kidneys, those with reflux due to obstruction had ARFI values (18.9+/-4.91 m/sec) higher than those with primary reflux (16.8+/-4.2 m/sec). The ARFI values of the affected kidneys significantly correlated with the serum cystatine levels (r=0.4342). CONCLUSION: CONCLUSION. These preliminary data demonstrate that ARFI quantification can provide reliable information about the severity of renal damage. CLINICAL RELEVANCE/APPLICATION: CLINICAL RELEVANCE STATEMENT. Being an accurate, non-invasive and radiation-free procedure, ARFI may prove useful in the diagnostic workout of children with chronic reflux-induced renal disease.

Acoustic Radiation Force Impulse (ARFI) Quantification of the Renal Parenchymal Stiffness in Paediatric Patients with Vescicoureteral Reflux: Preliminary Results

BRUNO, Costanza;POZZI MUCELLI, Roberto
2011-01-01

Abstract

PURPOSE: PURPOSE. To prospectively evaluate the tissue stiffness of the renal parenchyma in paediatric patients with chronic renal disease, by means of ARFI . METHOD AND MATERIALS: MATERIAL AND METHODS. 28 children (age range: 8 to 16 years) with vesicoureteral reflux (>/=grade III), either primary (18 cases) or due to obstruction (10 cases), underwent scintigraphy, blood analysis (cystatine C, creatinine, BUN) and ultrasound with ARFI. The results were compared with those obtained in 12 age-matched healthy controls who underwent blood analysis, ultrasound and ARFI. The results of ARFI examination were expressed as speed (m/sec) of wave propagation through tissues: the stiffer a tissue the faster the wave propagation. A global ARFI value was calculated for each kidney through the sum of the values (each of them resulting from the average of three different measurements) obtained at the upper, middle and lower third.The t-test per paired data was adopted. P values <0.05 were considered statistically significant. Pearson correlation coefficient was used to describe relationship between two variables. All data are reported as mean +/- standard deviation (confidence interval: 95%). RESULTS: RESULTS. The ARFI values obtained in the affected kidneys of the patients with renal disease (17.6+/-4.5 m/sec) were significantly higher than those measured in the controlateral unaffected kidney of the same patients (13.2+/-4.76 m/sec: p<0.017) and those measured in the kidneys of the healthy controls (9.3+/-0.18 m/sec): p<0.001). The difference between the ARFI values in the unaffected kidneys of the patients with renal disease (13.2+/-4.76 m/sec) and the kidneys of the healthy controls (9.3+/-0.18 m/sec) was statistically significant too (p<0.04). Among the affected kidneys, those with reflux due to obstruction had ARFI values (18.9+/-4.91 m/sec) higher than those with primary reflux (16.8+/-4.2 m/sec). The ARFI values of the affected kidneys significantly correlated with the serum cystatine levels (r=0.4342). CONCLUSION: CONCLUSION. These preliminary data demonstrate that ARFI quantification can provide reliable information about the severity of renal damage. CLINICAL RELEVANCE/APPLICATION: CLINICAL RELEVANCE STATEMENT. Being an accurate, non-invasive and radiation-free procedure, ARFI may prove useful in the diagnostic workout of children with chronic reflux-induced renal disease.
2011
ARFI; Pediatrics Genitourinary; chronic renal disease
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/379611
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