The role of strain wave elastography in the evaluation of renal fibrosis in patients with kidney diseases

IF 2 4区医学 Q2 UROLOGY & NEPHROLOGY

Nefrologia Pub Date : 2025-03-01 DOI:10.1016/j.nefro.2024.10.007

Hanaa Ibrahim Okda , Rabab Alaa Eldin Keshk , Noha El-Anwar , Ahmed Mohammed El Behiry , Sally Maher Gamaleldin

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Abstract

Background

A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy.

Method

For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE.

Results

In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915.

Conclusion

SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice.

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应变波弹性成像在肾病患者肾纤维化评价中的作用

背景：肾活检是慢性肾脏病和肾小球肾炎患者诊断、预后和治疗的金标准。应变波弹性成像（SE）是一种新兴的组织弹性评估技术。本研究的目的是探讨肾实质应变指数值与肾活检检测到的肾纤维化程度之间的相关性。方法对68例行肾活检的患者进行SE检测。采用Banff评分系统对IFTA对肾纤维化的分级进行分类，将严重程度分为轻度、中度和重度。采用受试者工作特征曲线（ROC）分析肾纤维化严重程度与SE测定的肾弹性分级之间的相关性。结果男性38例，女性30例，超声、定性和半定量弹性成像与血清肌酐、纤维化率、G评分、肾小管萎缩呈显著正相关，与eGFR呈显著负相关。SE诊断间质纤维化的ROC曲线显示，回声增强的灵敏度为100.0%，特异性为62.5%，阳性预测值（PPV）为75.0%，阴性预测值（NPV）为100.0%，曲线下面积（AUC）为0.906；定性弹性成像的灵敏度为77.8%，特异性为75.0%，PPV为77.8%，NPV为75.0%，AUC为0.833；半定量弹性成像的灵敏度为83.3%，特异性为93.8%，PPV为93.8%，NPV为83.3%，AUC为0.915。结论se入路简便，可区分肾纤维化的不同分期。然而，在将其广泛应用于临床实践之前，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nefrologia 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

7.70%

发文量

148

审稿时长

47 days

期刊介绍： Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.