Renal Parankimin Değerlendirilmesinde Shear Wave Elastografi ve Dimerkaptosüksinik Asit (DMSA) Bulgularının Karşılaştırılması
Öz
Amaç: Dimerkaptosüksinik asit (DMSA) renal kortikal sintigrafi renal skar dokusunun (RSD) noninvaziv tanısı için referans standart inceleme yöntemi olmakla birlikte düşük dozda radyasyon içerir. Shear wave elastografi (SWE) son zamanlarda RSD incelemesinde böbrek sertliğini ölçmek için kolay uygulanabilir, radyasyon içermeyen bir teknik olarak ortaya çıkmıştır. Bu çalışmanın amacı DMSA ve SWE testlerini karşılaştırmak ve SWE'nin hastalarda DMSA yerine kullanılıp kullanılamayacağını değerlendirmektir.
Gereç ve Yöntemler: Bu çalışmaya Ocak 2017 ile Mayıs 2024 tarihleri arasında çeşitli endikasyonlarla DMSA incelemesi yapılmış hastalarda prospektif olarak her iki böbreğe elastografi yapılan 72 hasta dahil edildi. SWE değerleri ve sertlik ortalama, standart sapma (SD), medyan, çeyrekler arası aralık (IQR) ve IQR/medyan değerleri kaydedildi. İlgi bölgeleri üst, orta ve alt kutupların her birinden üçer tane olmak üzere dokuz alanda ölçülmüş ve ortalama değerler hesaplanmıştır.
Bulgular: Hastaların yaş ortalaması 21.8±12.9 yıl idi. Hastaların 47'sinde (%33.1) ektopik böbrek, 48'inde (%33.8) at nalı böbrek vardı. Ortalama SWE değeri 7.06±1.1 kPa, sertlik ortalaması 8.63±5.2 kPa, sertlik SD'si 5.77±3.5 kPA, sertlik medyanı 4.15±2.3 kPa, sertlik IQR'si 1.20±1.0 kPa ve sertlik IQR/medyan %16.9±15.1 idi. SWE değeri ile DMSA sonuçları arasında istatistiksel olarak anlamlı bir korelasyon gözlenmiştir (p=0.002).
Sonuç: SWE değeri renal parankimi değerlendirmede başarılıdır ve DMSA sonuçları ile anlamlı korelasyon göstermektedir.
Anahtar Kelimeler
Shear wave elastografi DMSA böbrek kronik böbrek hastalığı ultrasonografi
Etik Beyan
Makale adana şehir eğitim ve araştırma hastanesi etik kurulundan onayını almıştır.(2024/3145)
Proje Numarası
2024/3145
Kaynakça
- 1.Goya C, Kilinc F, Hamidi C, et al. Acoustic radiation force impulse imaging for evaluation of renal parenchyma elasticity in diabetic nephropathy. Am J Roentgenol. 2015;204(2):324-329. [Crossref]
- 2.Marticorena Garcia SR, Grossmann M, Lang ST, et al. Tomoelastography of the native kidney: regional variation and physiological effects on in vivo renal stiffness. Magn Reson Med. 2018;79(4):2126-2134. [Crossref]
- 3.Hassan K, Loberant N, Abbas N, Fadi H, Shadia H, Khazim K. Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease. Ther Clin Risk Manag. 2016;12:1615-1622. [Crossref]
- 4.Sommerer C, Scharf M, Seitz C, et al. Assessment of renal allograft fibrosis by transient elastography. Transpl Int. 2013;26(5):545-551. [Crossref]
- 5.Arndt R, Schmidt S, Loddenkemper C, et al. Noninvasive evaluation of renal allograft fibrosis by transient elastography—a pilot study. Transpl Int. 2010;23(9):871-877. [Crossref]
- 6.Zaheer J, Shanmugiah J, Kim S, et al. 99mTc-DMSA and 99mTc-DTPA identified renal dysfunction due to microplastic polyethylene in murine model. Chemosphere. 2024;364:143108. [Crossref]
- 7.Paulini F, Marangon ARM, Azevedo CL, et al. In vivo evaluation of DMSA-coated magnetic nanoparticle toxicity and biodistribution in rats: a long-term follow-up. Nanomaterials (Basel). 2022;12(19):3513. [Crossref] 8.Koc AS, Sumbul HE. Renal cortical stiffness obtained by shear wave elastography imaging is increased in patients with type 2 diabetes mellitus without diabetic nephropathy. J Ultrasound. 2018;21(4):279-285. [Crossref]
- 9.Bob F, Grosu I, Sporea I, et al. Ultrasound-based shear wave elastography in the assessment of patients with diabetic kidney disease. Ultrasound Med Biol. 2017;43(10):2159-2166. [Crossref]
- 10.Salan A, Menzilcioglu MS, Guler AG, Dogan K. Comparison of shear wave elastography and dimercaptosuccinic acid renal cortical scintigraphy in pediatric patients. Nucl Med Commun. 2023;44(8):691-696. [Crossref]
- 11.Yadav AK, Sherwani P, Yhoshu E, et al. Diagnostic accuracy of shear wave elastography in evaluating renal fibrosis in children with chronic kidney disease: a comparative study with nuclear scan. Egypt J Radiol Nucl Med. 2023;54:110. [Crossref]
- 12.Wang J, Zhang F, Ma Y, et al. The application of shear wave quantitative ultrasound elastography in chronic kidney disease. Technol Health Care. 2024;32(5):2951-2964. [Crossref]
- 13.Tiwari K, Mittal A, Sureka B, et al. Utility of shear wave elastography in evaluation of children with chronic kidney disease. Pediatr Nephrol. 2024;40:2021-2028. [Crossref]
- 14.Davis LM, Martinez-Correa S, Freeman CW, et al. Ultrasound innovations in abdominal radiology: techniques and clinical applications in pediatric imaging. Abdom Radiol. 2024;50:1744-1762. [Crossref]
Comparison of Shear Wave Elastography and Dimercaptosuccinic Acid Findings in the Evaluation of Renal Parenchyma
Öz
Purpose: Dimercaptosuccinic acid (DMSA) renal cortical scintigraphy is the reference standard for the non-invasive diagnosis of renal scar tissue; however, it involves exposure to low doses of radiation. Shear wave elastography (SWE) has recently emerged as a radiation-free, easily applicable technique to measure renal stiffness in renal scar tissue examination. This study aimed to compare the results of DMSA and SWE tests and evaluate whether SWE could serve as an alternative to DMSA in patients.
Materials and Methods: This study included 72 patients who underwent elastography of both kidneys prospectively between January 2017 and May 2024 in patients who underwent DMSA examination for various indications. SWE values and stiffness average, standard deviation (SD), median, interquartile range (IQR), and IQR/median values were recorded. Regions of interest were measured in nine areas, three from each of the upper, middle, and lower poles, and mean values were calculated.
Results: The mean age of the patients was 21.8±12.9 years. Among the patients, 47 (33.1%) had ectopic kidneys, and 48 (33.8%) had horseshoe kidneys. The mean SWE value was 7.06±1.1 kPa, the stiffness average was 8.63±5.2 kPa, the stiffness SD was 5.77±3.5 kPA, the stiffness median was 4.15±2.3 kPa, the stiffness IQR was 1.20±1.0 kPa, and the stiffness IQR/median was 16.9±15.1%. A statistically significant correlation was observed between the SWE value and DMSA results (p=0.002).
Conclusion: The SWE value is successful in evaluating renal parenchyma and shows significant correlation with DMSA results.
Anahtar Kelimeler
Shear wave elastography DMSA kidney chronic kidney disease ultrasonography
Etik Beyan
The article was approved by the ethics committee of adana city training and research hospital.(2024/3145)
Proje Numarası
2024/3145
Kaynakça
- 1.Goya C, Kilinc F, Hamidi C, et al. Acoustic radiation force impulse imaging for evaluation of renal parenchyma elasticity in diabetic nephropathy. Am J Roentgenol. 2015;204(2):324-329. [Crossref]
- 2.Marticorena Garcia SR, Grossmann M, Lang ST, et al. Tomoelastography of the native kidney: regional variation and physiological effects on in vivo renal stiffness. Magn Reson Med. 2018;79(4):2126-2134. [Crossref]
- 3.Hassan K, Loberant N, Abbas N, Fadi H, Shadia H, Khazim K. Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease. Ther Clin Risk Manag. 2016;12:1615-1622. [Crossref]
- 4.Sommerer C, Scharf M, Seitz C, et al. Assessment of renal allograft fibrosis by transient elastography. Transpl Int. 2013;26(5):545-551. [Crossref]
- 5.Arndt R, Schmidt S, Loddenkemper C, et al. Noninvasive evaluation of renal allograft fibrosis by transient elastography—a pilot study. Transpl Int. 2010;23(9):871-877. [Crossref]
- 6.Zaheer J, Shanmugiah J, Kim S, et al. 99mTc-DMSA and 99mTc-DTPA identified renal dysfunction due to microplastic polyethylene in murine model. Chemosphere. 2024;364:143108. [Crossref]
- 7.Paulini F, Marangon ARM, Azevedo CL, et al. In vivo evaluation of DMSA-coated magnetic nanoparticle toxicity and biodistribution in rats: a long-term follow-up. Nanomaterials (Basel). 2022;12(19):3513. [Crossref] 8.Koc AS, Sumbul HE. Renal cortical stiffness obtained by shear wave elastography imaging is increased in patients with type 2 diabetes mellitus without diabetic nephropathy. J Ultrasound. 2018;21(4):279-285. [Crossref]
- 9.Bob F, Grosu I, Sporea I, et al. Ultrasound-based shear wave elastography in the assessment of patients with diabetic kidney disease. Ultrasound Med Biol. 2017;43(10):2159-2166. [Crossref]
- 10.Salan A, Menzilcioglu MS, Guler AG, Dogan K. Comparison of shear wave elastography and dimercaptosuccinic acid renal cortical scintigraphy in pediatric patients. Nucl Med Commun. 2023;44(8):691-696. [Crossref]
- 11.Yadav AK, Sherwani P, Yhoshu E, et al. Diagnostic accuracy of shear wave elastography in evaluating renal fibrosis in children with chronic kidney disease: a comparative study with nuclear scan. Egypt J Radiol Nucl Med. 2023;54:110. [Crossref]
- 12.Wang J, Zhang F, Ma Y, et al. The application of shear wave quantitative ultrasound elastography in chronic kidney disease. Technol Health Care. 2024;32(5):2951-2964. [Crossref]
- 13.Tiwari K, Mittal A, Sureka B, et al. Utility of shear wave elastography in evaluation of children with chronic kidney disease. Pediatr Nephrol. 2024;40:2021-2028. [Crossref]
- 14.Davis LM, Martinez-Correa S, Freeman CW, et al. Ultrasound innovations in abdominal radiology: techniques and clinical applications in pediatric imaging. Abdom Radiol. 2024;50:1744-1762. [Crossref]
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | 2024/3145 |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 24 Ocak 2025 |
| Kabul Tarihi | 20 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 8 Sayı: 2 |
