Pre-procedural shear wave elastography on prediction of hemorrhage after percutaneous real-time ultrasound-guided renal biopsy.

Abstract

To evaluate the relationship between renal elasticity which was determined with shear wave elastography (SWE) and hemorrhage in patients who undergone percutaneous renal parenchyma biopsy (PRB). In total, 60 patients who were performed ultrasound-guided PRB after the B-mode ultrasonography and SWE assessment were recruited in this study. All patients' serum creatinine, blood urea nitrogen and coagulation tests before PRB were obtained from medical records. The patients were divided into two groups who did and did not develop hemorrhage after PRB. We investigated whether there was any statistically significant difference between the two groups in terms of laboratory findings, B-mode ultrasonographic measurements and SWE measurements. Of the 60 patients, 23 (38.3%) had post-procedure hemorrhage and 37 (61.7%) had not. Mean hemorrhage size was 17.04mm (7-50mm). The mean value of renal cortical shear wave velocity of all patients was 1.91m/s (0.96-3.57m/sn). Patients with post-procedure hemorrhage had significantly lower mean shear wave velocity compared with patients with no hemorrhage (p < 0.05). ROC curve analysis suggested that the optimum SWV cutoff point for hemorrhage presence was 1.21m/sn, with 39.1% sensitivity and 97.3% specificity. There was no other statistically significant demographic, ultrasonographic or laboratory value differences between two groups. Although shear wave velocities have low sensitivity for hemorrhage after renal biopsy, high specificity and statistically significant difference in hemorrhage and non-hemorrhage group suggest that patients who have lower renal cortical shear wave velocity have a tendency to hemorrhage after PRB.