Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Pediatric Urology, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ultrasonography. 2014 Apr;33(2):116-21. doi: 10.14366/usg.14002. Epub 2014 Feb 26.
To measure shear wave velocities (SWVs) by acoustic radiation force impulse (ARFI) ultrasound elastography in normal kidneys and in hydronephrotic kidneys in young children and to compare SWVs between the hydronephrosis grades.
This study was approved by an institutional review board, and informed consent was obtained from the parents of all the children included. Children under the age of 24 months were prospectively enrolled. Hydronephrosis grade was evaluated on ultrasonography, and three valid ARFI measurements were attempted using a high-frequency transducer for both kidneys. Hydronephrosis was graded from 0 to 4, and high-grade hydronephrosis was defined as grades 3 and 4.
Fifty-one children underwent ARFI measurements, and three valid measurements for both kidneys were obtained in 96% (49/51) of the patients. Nineteen children (38.8%) had no hydronephrosis. Twenty-three children (46.9%) had unilateral hydronephrosis, and seven children (14.3%) had bilateral hydronephrosis. Seven children had ureteropelvic junction obstruction (UPJO). Median SWVs in kidneys with high-grade hydronephrosis (2.02 m/sec) were higher than those in normal kidneys (1.75 m/sec; P=0.027). However, the presence of UPJO did not influence the median SWVs in hydronephrotic kidneys (P=0.362).
Obtaining ARFI measurements of the kidney is feasible in young children with median SWVs of 1.75 m/sec in normal kidneys. Median SWVs increased in high-grade hydronephrotic kidneys but were not different between hydronephrotic kidneys with and without UPJO.
应用声辐射力脉冲（ARFI）超声弹性成像测量正常肾脏和小儿积水肾脏的剪切波速度（SWV），并比较不同积水程度间的 SWV。
本研究经机构审查委员会批准，并获得所有纳入儿童家长的知情同意。前瞻性纳入 24 个月以下的儿童。超声检查评估肾盂积水程度，使用高频探头对双侧肾脏各尝试 3 次有效的 ARFI 测量。积水程度分为 0-4 级，3-4 级为重度积水。
51 例儿童进行了 ARFI 测量，96%（49/51）的患者双侧肾脏均获得 3 次有效的测量。19 例（38.8%）无肾盂积水，23 例（46.9%）单侧积水，7 例（14.3%）双侧积水。7 例存在肾盂输尿管连接部梗阻（UPJO）。重度积水肾脏的 SWV 中位数（2.02 m/sec）高于正常肾脏（1.75 m/sec；P=0.027）。然而，UPJO 的存在并不影响积水肾脏的 SWV 中位数（P=0.362）。
在小儿中获取肾脏 ARFI 测量是可行的，正常肾脏的 SWV 中位数为 1.75 m/sec。重度积水肾脏的 SWV 中位数增加，但有无 UPJO 的积水肾脏间无差异。
