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Acoustic radiation force impulse (ARFI) elastography in the evaluation of renal parenchymal stiffness in patients with ureteropelvic junction obstruction

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Abstract

Purpose

To investigate the role of acoustic radiation force impulse (ARFI) elastography in the detection of renal parenchymal damage in kidneys with and without ureteropelvic junction obstruction (UPJO).

Methods

Twenty-five pediatric patients with a diagnosis of UPJO who underwent surgery and 15 pediatric patients with conservatively managed UPJO were prospectively evaluated with ARFI elastography. Sixteen healthy volunteers constituted the control group. Shear wave velocity (SWV) measurements in the upper, mid, and lower poles of the affected kidney were performed. SWV values of kidneys based on presence of UPJO and hydronephrosis grade were compared. The correlation of SWV values with residual renal function obtained from diethylenetriaminepentaacetic acid or mercaptoacetyltriglycine-3 renal scan was evaluated.

Results

Significantly, higher SWV values were found in control kidneys compared to kidneys affected by UPJO. The median SWVs were 2.82 (2.51–3.07) m/s for the control kidneys and 2.36 (2.09–2.53) m/s for the kidneys in the UPJO group (p < 0.001). When UPJO patients were grouped according to the grade of hydronephrosis, grade 0 hydronephrotic kidneys [2.35 (2.11–2.50) m/s] and grade 3–4 hydronephrotic kidneys [1.86 (1.96–2.25) m/s] had significantly lower SWV values compared to grade 1–2 hydronephrotic kidneys [2.62 (2.37–2.90) m/s] (p < 0.05).

Conclusions

ARFI as a noninvasive, radiation-free procedure for evaluating parenchymal stiffness may prove useful in the diagnostic work-up and follow-up of children with UPJO-induced renal disease.

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Authors and Affiliations

  1. Department of Radiology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey

    Hatice Arioz Habibi, Sedat Giray Kandemirli, Emel Ure, Ayse Kalyoncu Ucar, Mine Aslan & Ibrahim Adaletli

  2. Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey

    Rumeysa Yasemin Cicek & Salim Caliskan

Authors
  1. Hatice Arioz Habibi
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  2. Rumeysa Yasemin Cicek
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  3. Sedat Giray Kandemirli
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  4. Emel Ure
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  5. Ayse Kalyoncu Ucar
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  6. Mine Aslan
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  7. Salim Caliskan
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  8. Ibrahim Adaletli
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Corresponding author

Correspondence to Sedat Giray Kandemirli.

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Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

All authors state that they have no conflict of interest to declare.

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Habibi, H.A., Cicek, R.Y., Kandemirli, S.G. et al. Acoustic radiation force impulse (ARFI) elastography in the evaluation of renal parenchymal stiffness in patients with ureteropelvic junction obstruction. J Med Ultrasonics 44, 167–172 (2017). https://doi.org/10.1007/s10396-016-0760-7

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  • DOI: https://doi.org/10.1007/s10396-016-0760-7

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