Preliminary study of the acoustic radiation force impulse imaging in diagnosis and treatment of IgA nephropathy

Abstract

Objective To investigate the value of acoustic radiation force impulse (ARFI) on evaluating the renal tubular atrophy and interstitial fibrosis of IgA nephropathy(IgAN).Methods 117 patients diagnosed with IgAN,and 80 normal cases were examined with conventional ultrasonography and ARFI,recording the shear wave velocities(SWV),the hemodynamics and the renal biopsy results to quantify the elastic changes of renal cortex,with the aim of assessing AFRI's advantages on early diagnosing the impair of kidney.Results The SWV value of renal cortex,renal medulla of IgAN group were smaller than that of normal group (P ＜0.05),while the collective system SWV value had no difference(P ＞0.05).According to the ROC curve,the cut-off value of SWV in renal cortex was 2.7 cm/s.The accuracy of the diagnosis was 71 ％,which was better than RI (61.9％).The SWV value of the renal cortex decreased with the different stage of 1,2,3,4,but stage 5 was larger than stage 4.The degree of renal tubular atrophy and interstitial fibrosis(T) can be classified by the SWV of renal cortex,and the SWV of T2 was larger than T1 (P ＜0.05).Conclusions By quantifying the elastic change of kidney,ARFI technology is able to distinguish the degree of renal tubular atrophy and interstitial fibrosis,diagnose renal impairment early and judge the clinical stages.Furthermore the sensitivity,specificity,accuracy of it are superior to hemodynamic. Key words: Ultrasonopgraphy; Glomerulonephritis, IgA; Acoustic radiation force impulse