Granata Antonio, Distefano Giulio, Maccarrone Rosario, Pesce Francesco, Costanza Giuseppa, Digiacomo Antonio, Basile Antonio, Romano Marcello, Cantisani Vito
U.O.C. Nefrologia e Dialisi, A.O. per l'emergenza "Cannizzaro" - Catania (CT), Italia.
U.O.C. Medicina Generale, Dipartimento di Medicina, Ospedale "R. Guzzardi" di Vittoria, ASP Ragusa, Ragusa, Italia.
G Ital Nefrol. 2022 Aug 29;39(4):2022-vol4.
Chronic kidney disease is characterized by increasingly amplified fibrotic processes regardless of etiology. The severity of renal fibrosis seems to correlate with an increased risk of end-stage renal disease; therefore, monitoring of renal fibrosis over time may play an important role in the follow-up of both focal and diffuse renal diseases and in evaluating the response to treatments. Renal biopsy is the only method capable of providing objective and comparable information on the extent of fibrosis, but it is not suitable for outpatient monitoring of chronic kidney disease due to its invasiveness. Elastosonography is an innovative and non-invasive ultrasound method that allows the measurement of tissue elasticity through the transmission of mechanical waves and the measurement of their propagation speed. Although some authors have demonstrated the usefulness of elastosonographic techniques for the quantification of liver fibrosis, few studies have investigated the applications of elastosonography in renal pathology. Furthermore, the depth of native kidneys, the high anisotropy of the renal tissue, and the possibility of examining only a small region of interest currently limit its spread in clinical practice. The aim of this review is to examine the physical principles of elastosonography and to review the latest evidence about the possible applications of the ARFI (acoustic radiation force impulse) technique in the study of kidney diseases.
慢性肾脏病的特征是无论病因如何，纤维化过程都会日益加剧。肾纤维化的严重程度似乎与终末期肾病风险增加相关；因此，长期监测肾纤维化可能在局灶性和弥漫性肾脏疾病的随访以及评估治疗反应中发挥重要作用。肾活检是唯一能够提供关于纤维化程度的客观且可比信息的方法，但由于其具有侵入性，不适合用于慢性肾脏病的门诊监测。弹性超声检查是一种创新的非侵入性超声方法，它可以通过机械波的传播来测量组织弹性及其传播速度。尽管一些作者已经证明弹性超声技术在量化肝纤维化方面的有用性，但很少有研究探讨弹性超声检查在肾脏病理学中的应用。此外，肾脏的深度、肾组织的高各向异性以及只能检查小感兴趣区域的可能性目前限制了其在临床实践中的推广。本综述的目的是研究弹性超声检查的物理原理，并回顾关于声辐射力脉冲（ARFI）技术在肾脏疾病研究中可能应用的最新证据。
