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CC BY 4.0 · Ultraschall Med
DOI: 10.1055/a-2559-7743
Original Article

Multimodal Ultrasound for Assessment of Renal Fibrosis in Biopsy-Proven Patients with Chronic Kidney Disease

Multimodaler Ultraschall zur Beurteilung der Nierenfibrose bei Patienten mit einer durch Biopsie bestätigten chronischen Nierenerkrankung
Xinyue Huang‡
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
2   Department of Ultrasound, Nanchang University Second Affiliated Hospital, Nanchang, China (Ringgold ID: RIN196534)
,
Tianhong Wei‡
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
,
Jie Li
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
,
Letian Xu
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
,
Yangshuo Tang
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
,
Jin-Tang Liao
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
,
Bo Zhang 
1   Department of Ultrasound Imaging, Xiangya Hospital Central South University, Changsha, China (Ringgold ID: RIN159374)
› InstitutsangabenGefördert durch: Natural Science Foundation of Hunan Province 2022JJ30982
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Abstract

Objectives

To establish a discriminant function model combining clinical data and multimodal ultrasound to predict the degree of renal fibrosis in patients with chronic kidney disease (CKD) and to explore the application value of the non-invasive assessment of renal fibrosis by new ultrasound techniques.

Methods

Clinical data and ultrasonography, shear wave elastography, and angio planewave ultrasensitive imaging characteristics of patients with CKD were collected. The significant indicators were screened to establish discriminant function models to distinguish the degree of renal fibrosis, and the diagnostic efficacy was evaluated.

Results

The 158 patients were divided into 4 groups according to pathological results. The significant indicators among or within the 4 groups were mainly age, estimated glomerular filtration rate, serum creatinine, peak systolic velocity and resistance index of renal arteries, kidney elasticity, and arcuate artery vascular density (p<0.05). The discriminant function models exhibited good diagnostic efficiency and higher accuracy compared to any single indicator.

Conclusion

The SWE elasticity value of the kidney increases with the degree of fibrosis, while AP can visualize microvascular conditions qualitatively and quantitatively. Multimodal ultrasound combined with clinical data is a non-invasive strategy for the assessment of renal fibrosis.

Zusammenfassung

Ziel

Entwicklung eines Diskriminanz-Modells, das klinische Daten und multimodalen Ultraschall kombiniert, um den Grad der Nierenfibrose bei Patienten mit chronischer Nierenerkrankung (CKD) vorherzusagen, und um den Nutzen der nicht invasiven Bewertung der Nierenfibrose mittels neuer Ultraschalltechniken zu untersuchen.

Material und Methoden

Von Patienten mit CKD wurden klinische Daten und Bildgebungsmerkmale aus Ultraschall, Scherwellen-Elastografie und „Angio Planewave Ultrasensitive Imaging“ gesammelt. Die signifikanten Indikatoren wurden ausgewertet, um Diskriminanz-Modelle zur Feststellung des Grades der Nierenfibrose zu erstellen, und deren diagnostische Aussagekraft wurde bewertet.

Ergebnisse

158 Patienten wurden anhand der pathologischen Befunde in 4 Gruppen eingeteilt. Die signifikanten Indikatoren zwischen den 4 Gruppen oder innerhalb von ihnen waren hauptsächlich Alter, geschätzte glomeruläre Filtrationsrate, Serumkreatinin, systolische Spitzengeschwindigkeit und Widerstandsindex der Nierenarterien, die Nierenelastizität und die Gefäßdichte der Arteria arcuata (p<0,05). Die Diskriminanz-Modelle zeigten eine gute diagnostische Aussagekraft und eine höhere Genauigkeit im Vergleich zu jedem einzelnen Indikator.

Schlussfolgerung

Der SWE-Elastizitätswert der Niere steigt mit dem Grad der Fibrose, während AP mikrovaskuläre Zustände qualitativ und quantitativ darstellen kann. Der multimodale Ultraschall in Kombination mit klinischen Daten stellt eine nicht invasive Strategie zur Beurteilung der Nierenfibrose dar.

Keywords

Chronic kidney disease - Renal fibrosis - Shear Wave Elastography - Multimodal ultrasound - Angio Planewave Ultrasensitive Imaging


Publikationsverlauf

Eingereicht: 13. September 2024

Angenommen nach Revision: 03. März 2025

Artikel online veröffentlicht:
31. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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