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Contrast-enhanced ultrasonography in chronic glomerulonephritides: correlation with histological parameters of disease activity

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Abstract

Purpose

To compare contrast-enhanced ultrasonography (CEUS)-derived time-intensity (TI) curves with histological findings in kidneys of patients affected by chronic glomerulonephritides (GN) in the early stage of disease.

Methods

Research ethics committee approval and patient written informed consent were obtained. Thirty-one patients who showed clinical and laboratory signs of GN, with preserved renal function, were consecutively enrolled. They underwent kidney CEUS, from which TI curves were obtained, and kidney biopsy. TI curves were compared with clinical data, ultrasound (US) Doppler, and histological parameters.

Results

The persistence of contrast agent signal during the wash-out phase was found to be correlated with the degree of disease activity (p = 0.016) and in particular with the presence of mesangial hyperplasia (p = 0.008). No correlation was observed between TI curves and clinical or Doppler US-derived parameters.

Conclusions

The persistence of contrast agent signal in the wash-out phase of CEUS appears to reflect a disturbance of perfusion in glomerular capillaries in the early stages of GN. We found that the histological element directly correlated with the prolonged wash-out was mesangial hyperplasia.

Sommario

Scopo

Confrontare le curve intensità-tempo (TI) derivate dallo studio ecografico con mezzo di contrasto (CEUS) con i reperti istologici dei reni in pazienti affetti da glomerulonefrite (GN) cronica nelle fasi iniziali di malattia

Metodi

Abbiamo dunque arruolato 31 pazienti con segni clinici e laboratoristici di GN e con funzione renale conservata. Costoro sono stati sottoposti a CEUS e biopsia renali. Si è quindi proceduto alla valutazione della curve TI rispetto ai parametri clinici, eco Doppler e istologici

Risultati

La persistenza del mezzo di contrasto nella fase di wash-out correla con il grado di attività di malattia, ed in particolare con la presenza di iperplasia mesangiale. Non sono state trovate correlazioni tra le curve TI ed i dati eco Doppler e clinici

Conclusioni

Nelle fasi iniziali delle GN, la persistenza del mezzo di contrasto durante la fase di wash-out sembra documentare una condizione di alterata perfusione nei capillari glomerulari, direttamente correlata all’iperplasia mesangiale

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Author information

Authors and Affiliations

  1. Altamedica Artemisia, Viale Liegi 45, 00198, Rome, Italy

    Manuela Nestola

  2. Gastroenterology Unit, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Nicoletta De Matthaeis, Fabrizio Pizzolante & Gian Ludovico Rapaccini

  3. Nephrology Unit, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Pietro Manuel Ferraro, Stefano Costanzi & Giovanni Gambaro

  4. Department of Woman and Child Health, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Paola Fuso

  5. Pathology Unit, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Gian Franco Zannoni

  6. Radiology Unit, Policlinico A. Gemelli, Catholic University, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Sabina Vasquez Quadra

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  1. Manuela Nestola
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  10. Gian Ludovico Rapaccini
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Correspondence to Manuela Nestola.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed written consent was obtained from all patients included in the study.

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Nestola, M., De Matthaeis, N., Ferraro, P.M. et al. Contrast-enhanced ultrasonography in chronic glomerulonephritides: correlation with histological parameters of disease activity. J Ultrasound 21, 81–87 (2018). https://doi.org/10.1007/s40477-018-0298-1

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  • DOI: https://doi.org/10.1007/s40477-018-0298-1

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