Shear Wave Ultrasound Elastography to Evaluate the State of Renal Transplant
The aim of the study was to assess possibilities of shear wave ultrasound elastography in evaluating severity of fibrosis of a renal transplant aged from 1 to 3 years and older.
Materials and Methods. In the period from February 9, 2015 to May 25, 2017 we performed 80 ultrasound scans in 44 patients, whose average age was 34.8±8.9 (from 17 to 52 years old). Ultrasound scans were performed on Aixplorer (Super Sonic Imagine S.A., Aixen-Provence, France) with a convex transducer with frequency range 1–6 MHz. The patients were divided into two groups: group 1 (n=12) — patients with a stable function of their renal transplant, group 2 (n=32) — patients with deviations in clinical laboratory values (increased creatinine level in blood serum), with recurrent glomerulonephritis and other complications.
Results. In group 1 (n=12, average age — 36.6±2.1), the average measurements of the transplant were the following: length — 120.4±9.7 mm; width — 48.8±5.5 mm; parenchyma thickness — 14.8±2.1 mm. In group 2 (n=32, average age — 42.9±2.4), the measurements of a transplanted kidney were as follows: length — 116.8±7.9 mm; width — 49.1±4.4 mm; parenchyma thickness — 15.4±2.3 mm. The average resistance index in interlobar arteries in group 1 was 0.69±0.09; in group 2 it was 0.72±0.03 (p=0.673). In arcuate arteries the resistance index was 0.62±0.08 in group 1 and 0.73±0.01 in group 2. The values of parenchyma stiffness of a renal transplant in shear wave ultrasound elastography in different areas were 26.14±1.50 kPa in group 1 and 28.75±0.76 kPa in group 2 (p=0.0099). The level of creatinine in the patients from group 1 was 143.3±11.9 µmol/L and in group 2 it was 161.8±9.0 µmol/L (p=0.268). The correlation ratio r of the values of creatinine and parenchyma stiffness in group 1 was equal to 0.452; in group 2, r was 0.375 which is statistically significant.
Conclusion. On the basis of the results of the statistical processing of the data we determined diagnostic significance of shear wave ultrasound elastography for evaluation of the state of a transplanted kidney in short and long terms of follow-up.
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