Moon Sung Kyoung, Kim Sang Yoon, Cho Jeong Yeon, Kim Seung Hyup
Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea (S.K.M.); and Department of Radiology, Seoul National University Hospital, Seoul, Korea (S.Y.K., J.Y.C., S.H.K.).
Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea (S.K.M.); and Department of Radiology, Seoul National University Hospital, Seoul, Korea (S.Y.K., J.Y.C., S.H.K.)
J Ultrasound Med. 2015 May;34(5):869-77. doi: 10.7863/ultra.34.5.869.
The purpose of this study was to evaluate the feasibility of ultrasonic shear wave elastography for quantification of renal fibrosis in an experimental rabbit model.
Thirty-eight kidneys of 19 rabbits were studied and categorized into 3 groups: group I, ureter obstruction (n = 9); group II, renal vein occlusion (n = 10); and group III, normal control (n = 19). Before surgery, we measured stiffness at the renal cortex using shear wave elastography and evaluated the sonographic findings, including size, echogenicity, and resistive index. We repeated the same sonographic examinations weekly until the fourth week. The degree of histologically quantified fibrosis and the measured stiffness values were statistically compared.
There was no significant difference in the mean stiffness values for the renal cortex in the 3 groups before surgery (8.95 kPa in group I, 9.06 kPa in group II, and 9.74 kPa in group III; P > .05). However, the mean stiffness in each group on the last sonographic examination was significantly different (10.91 kPa in group I, 13.92 kPa in group II, and 9.77 kPa in group III; P = .003). Pathologically, the degree of fibrosis was also significantly different (3.62% in group I, 11.70% in group II, and 0.70% in group III; P< .001). The fibrosis degree and stiffness were positively correlated (ρ = 0.568; P = 0.01).
Tissue stiffness measured by ultrasonic shear wave elastography was positively correlated with histopathologic renal fibrosis. Ultrasonic shear wave elastography may be used as a noninvasive tool for predicting renal fibrosis.
本研究旨在评估超声剪切波弹性成像在实验性兔模型中量化肾纤维化的可行性。
对19只兔子的38个肾脏进行研究,并分为3组:第一组,输尿管梗阻(n = 9);第二组,肾静脉闭塞(n = 10);第三组,正常对照组(n = 19)。手术前,我们使用剪切波弹性成像测量肾皮质的硬度,并评估超声检查结果,包括大小、回声性和阻力指数。每周重复相同的超声检查,直至第四周。对组织学量化的纤维化程度和测量的硬度值进行统计学比较。
术前3组肾皮质的平均硬度值无显著差异(第一组为8.95 kPa,第二组为9.06 kPa,第三组为9.74 kPa;P > 0.05)。然而,最后一次超声检查时每组的平均硬度有显著差异(第一组为10.91 kPa,第二组为13.92 kPa,第三组为9.77 kPa;P = 0.003)。病理上,纤维化程度也有显著差异(第一组为3.62%,第二组为11.70%,第三组为0.70%;P < 0.001)。纤维化程度与硬度呈正相关(ρ = 0.568;P = 0.01)。
超声剪切波弹性成像测量的组织硬度与肾组织病理学纤维化呈正相关。超声剪切波弹性成像可作为预测肾纤维化的无创工具。