Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, Republic of Korea.
Department of Radiology, Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
J Ultrasound Med. 2021 Dec;40(12):2639-2653. doi: 10.1002/jum.15654. Epub 2021 Feb 18.
To estimate the technical performance of acoustic radiation force impulse (ARFI) imaging (two-dimensional shear wave elastography [2D-SWE] and point shear wave elastography [p-SWE]) for measuring renal parenchymal stiffness.
EMBASE and PubMed databases were searched for studies reporting technical performance of ARFI imaging in terms of technical failure, interobserver agreement, and/or intraobserver agreement. The proportion of technical failure and intraclass correlation coefficients (ICCs) for interobserver and intraobserver agreement was pooled. The pooled estimates of native and transplanted kidneys were obtained separately. Meta-regression and subgroup analyses were conducted to explore heterogeneity.
Twenty-four studies (2993 patients) were included. The pooled proportions of technical failure were 4.3% (95% confidence interval [CI] 2.2-8.5%) and 6.6% (95% CI 4.0-10.7%) in native and transplanted kidneys, respectively. The pooled ICCs of interobserver agreement were 0.70 (95% CI 0.68-0.83) and 0.81 (95% CI 0.68-0.89), indicating moderate and good agreement in native and transplanted kidneys, respectively. The pooled ICC showed good (0.77; 95% CI 0.49-0.91) intraobserver agreement in native kidneys. Regarding interobserver agreement in transplanted kidneys, ROI location (mid pole only versus others) was a significant factor of heterogeneity (P = .04).
The ARFI-based SWE techniques show good technical performance for measuring renal parenchymal stiffness. The wide range of SWE protocols necessitates development of standardized guidelines on the use of renal ARFI imaging.
评估声辐射力脉冲（ARFI）成像（二维剪切波弹性成像[2D-SWE]和单点剪切波弹性成像[p-SWE]）测量肾实质硬度的技术性能。
检索 EMBASE 和 PubMed 数据库，以获取报告 ARFI 成像技术性能的研究，包括技术失败、观察者间一致性和/或观察者内一致性。汇总技术失败比例和观察者间和观察者内一致性的组内相关系数（ICC）。分别获得原发性和移植肾的汇总估计值。进行荟萃回归和亚组分析以探索异质性。
共纳入 24 项研究（2993 例患者）。原发性和移植肾的技术失败比例分别为 4.3%（95%置信区间[CI] 2.2-8.5%）和 6.6%（95% CI 4.0-10.7%）。观察者间一致性的 ICC 汇总值分别为 0.70（95% CI 0.68-0.83）和 0.81（95% CI 0.68-0.89），表明原发性和移植肾的一致性为中度和良好。原发性肾的观察者内一致性的 ICC 为 0.77（95% CI 0.49-0.91），表现出良好的一致性。关于移植肾的观察者间一致性，感兴趣区（ROI）位置（仅中极与其他部位）是异质性的一个显著因素（P=0.04）。
基于 ARFI 的 SWE 技术在测量肾实质硬度方面具有良好的技术性能。广泛的 SWE 方案需要制定关于使用肾 ARFI 成像的标准化指南。
