Bilgici Meltem Ceyhan, Bekci Tumay, Genc Gurkan, Tekcan Demet, Tomak Leman
Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
Zonguldak Atatürk State Hospital, Radiology Clinic, Zonguldak, Turkey.
J Ultrasound Med. 2017 Aug;36(8):1555-1561. doi: 10.7863/ultra.16.08033. Epub 2017 Apr 8.
To evaluate renal parenchymal elasticity with acoustic radiation force impulse imaging in pediatric patients with chronic kidney disease (CKD) and compare with healthy volunteers.
Thirty-eight healthy volunteers and 30 pediatric CKD patients were enrolled in this prospective study. The shear wave velocity (SW) values of both kidneys in CKD patients and healthy volunteers were evaluated.
The mean SW in healthy volunteers was 2.21 ± 0.34 m/s, whereas the same value was 1.81 ± 0.49, 1.72 ± 0.63, 1.66 ± 0.29, 1.48 ± 0.37, and 1.23 ± 0.27 for stages 1, 2, 3, 4, and 5 in CKD patients, respectively. The SW was significantly lower for each stage in the CKD patients compared with healthy volunteers. Acoustic radiation force impulse could not predict the different stages of CKD, with the exception of stage 5. The cut-off value for predicting CKD was 1.81 m/s; at this threshold, sensitivity was 76.5% and specificity was 92.1% (area under the curve = 0.870 [95% confidence interval: 0.750-0.990]; P < .001). Interobserver agreement expressed as intraclass coefficient correlation was 0.65 (95% confidence interval: 0.34 to 0.83; P < .001).
Acoustic radiation force impulse may be a potentially useful tool in detecting CKD in pediatric patients.
利用声辐射力脉冲成像评估慢性肾脏病（CKD）患儿的肾实质弹性，并与健康志愿者进行比较。
38名健康志愿者和30名CKD患儿纳入本前瞻性研究。对CKD患儿和健康志愿者双侧肾脏的剪切波速度（SW）值进行评估。
健康志愿者的平均SW为2.21±0.34m/s，而CKD患儿1、2、3、4和5期的该值分别为1.81±0.49、1.72±0.63、1.66±0.29、1.48±0.37和1.23±0.27。与健康志愿者相比，CKD患儿各期的SW均显著降低。除5期外，声辐射力脉冲无法预测CKD的不同分期。预测CKD的临界值为1.81m/s；在此阈值下，敏感性为76.5%，特异性为92.1%（曲线下面积=0.870[95%置信区间：0.750 - 0.990]；P<.001）。观察者间一致性以组内相关系数表示为0.65（95%置信区间：0.34至0.83；P<.001）。
声辐射力脉冲可能是检测CKD患儿的一种潜在有用工具。
