Abstract
Renal elastography is a real-time ultrasound-based imaging method that can potentially be used in order to assess diffuse diseases of native kidneys. In order to find a place in the clinical practice for renal elastography, what is influencing the obtained results should be known. The kidney shear wave speed is influenced by different factors such as age, gender, measurement depth or urinary pressure. The relationship with renal function and also with renal fibrosis is different across different studies, with not all studies showing an increase in renal stiffness in more advanced renal diseases. However, the changes in renal blood flow seem to influence renal elastography, and a decrease in renal blood flow could be the cause of the decrease in the shear wave speed and could have a bigger influence on elastography compared to renal fibrosis. This paper provides a summary about the factors that seem to influence renal elastography and also regarding the limitations of this method according to the published studies thus far.
Highlights
Chronic kidney disease (CKD) has an increasing incidence and prevalence, and its progression is associated with high morbidity, mortality and increased health costs [ ]
This paper provides a summary about the factors that seem to in uence renal elastography and regarding the limitations of this method according to the published studies far
Elastography is a real-time imaging method that could be useful in the assessment of the kidneys, with the technique having a good reproducibility between observers and showing a good technical performance for the measurement of renal parenchymal sti ness [ ]
Summary
Chronic kidney disease (CKD) has an increasing incidence and prevalence, and its progression is associated with high morbidity, mortality and increased health costs [ ]. The method can be used only for super cial kidneys, and renal transplants [ ] This method basically measures the tissue shear wave speed or velocity (SWV). (a) Transient Elastography (TE) is based on controlled external vibration that generates shear waves This method is mainly used for assessing the sti ness of liver tissue (Fibroscan). (b) Acoustic radiation force impulse (ARFI) excitation is based on focused acoustic radiation force pushing pulses that generate shear waves inside the organ These shear waves propagate and are progressively attenuated due to their absorption in the soft tissue, and their speed of propagation can be measured, resulting in the SWV. The information is reported as a color-coded map mosaic inside the ROI Systems that use this method are as follows: the D-SWE-SSI technique (Aixplorer) (Figure ), and D-SWE-GE (General Electric) (Figure ). For the assessment of native kidneys, especially for di use renal diseases, the last two mentioned methods (pSWE and D-SWE) seem to be suitable and will be referred to in this article
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