Die quantitative Messung der Echogenität des Nierenparenchyms

Tůma, Jan; Schwarzenbach, Hans-Rudolf; Novakova, Bozena; Jungius, K. P.; Kuchta, M.

doi:10.1024/1661-8157.97.6.297

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…There was no association between PN use at the time and these sonographic changes. It is, however, important to note that the diagnosis of increased renal parenchymal echogenicity can be subjective (38,39), with 1 study showing a mean variation of 3% between measurements obtained by 2 different individuals on identical sonographic images (38), and another study showing a coefficient of variation of 0.83 on repeated measurements made by 2 different individuals (40). Interoperator differences could, therefore, have affected these results to some degree.…”

Section: Discussionmentioning

confidence: 99%

Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure

Roberts

Belza²,

Wales³

et al. 2020

J. pediatr. gastroenterol. nutr.

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Background: Outcomes of pediatric intestinal failure (PIF) have improved recently, with other comorbidities, such as increased echogenicity/nephrocalcinosis on ultrasound (US) in long-term survivors now evident. We evaluated the significance of nephrocalcinosis over time in PIF and its impact on renal function. Methods: Retrospective analysis on a cohort of PIF patients was performed. Presence of nephrocalcinosis and/or increased renal echogenicity (identified on US), estimated glomerular filtration rate (eGFR; ml · min−1 · 1.73 m−2), renal tubular function, PN volume (ml · kg−1 · day−1) and PN exposure time (hours/day) were reviewed annually over a follow-up period of 2 years. Outcomes in the nephrocalcinosis versus normal US groups were compared. Results: Forty patients (28 boys, median age 2.7 years) were followed for 2 years. Fifteen (38%) had either increased echogenicity or nephrocalcinosis (group 1) at initial US. US were normal in the remaining 25 (62%) on initial assessment (group 2). eGFR did not differ between group 1 and group 2 at baseline (118 vs 133, P = 0.51) and year 2 (130 vs 131, P = 1.00). The percentage of patients with abnormal markers of tubular function was similar in both groups at year 2 (high urine calcium: creatinine 33 versus 30, P = 0.83; high urine calcium: citrate 39 versus 42, P = 0.87; low urine citrate: creatinine 15 versus 17, P = 1.00; high urine oxalate: creatinine 39 versus 25, P = 0.77). Conclusions: A large proportion of PIF patients with a history of parenteral nutrition (PN) exposure have nephrocalcinosis and/or increased echogenicity on US. Over a 2-year follow-up period, however, these abnormalities had no impact on eGFR or renal tubular function.

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Section: Discussionmentioning

confidence: 99%

Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure

Roberts

Belza²,

Wales³

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…Therefore, cases that account for the smallest and largest values are never misinterpreted. Second, variables that could affect renal cortical echogenicity, like the subject's state of hydration [19] or the administration of furosemide [21] were neglected. However, water loading determined a mean increase in echogenicity of only 6.4% [19] and the qualitatively furosemide effect was limited to the medullary pyramids [21].…”

Section: Discussionmentioning

confidence: 99%

“…Second, variables that could affect renal cortical echogenicity, like the subject's state of hydration [19] or the administration of furosemide [21] were neglected. However, water loading determined a mean increase in echogenicity of only 6.4% [19] and the qualitatively furosemide effect was limited to the medullary pyramids [21]. Although the assignment of an individual weighting echogenicity factor to an individual patient instead of a mean for each subset of patient seems more appropriate, it is difficult to integrate into clinical practice because it is cumbersome.…”

Section: Discussionmentioning

confidence: 99%

Sonographically determined kidney measurements are better able to predict histological changes and a low CKD-EPI eGFR when weighted towards cortical echogenicity

Araújo¹,

Rebelo²,

Rioja

et al. 2020

BMC Nephrol

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Background: The renal length and cortical echogenicity have shown correlation to the renal function and histological changes in CKD patients. The aim of this study was to assess the accuracy of crude and composite ultrasound parameters based on kidney measurements and cortical echogenicity to detect renal dysfunction and histological changes. Methods: Kidney sonography and biopsy were performed in 112 patients. Histological changes were graded in 0, < 25%, ≥25%, ≤50 and > 50% of the sample. Cortical echogenicity was graded relative to liver or spleen parenchyma: less than, equal to and higher than the liver/spleen. Kidney length, the kidney length/body height ratio (KL/H) and cortical thickness were obtained. Each parameter was multiplied by a cortical echogenicityweighting arbitrary factor: 1.17, 1 or 0.69 for cortex less than, equal to or higher than the liver, respectively. The GFR was estimated using the CKD-EPI formula. The accuracy of crude and composite parameters to identify patients with a high creatinine, a low GFR and histological changes were evaluated. Results: The discriminative power of kidney length and cortical thickness for renal dysfunction and histological changes was improved after weighting for cortical echogenicity. However, the best discriminative was the kidney length to height ratio weighted towards renal echogenicity (w-KL/H). Conclusion: w-KL/H exceeded the other parameters as a marker of renal impairment and histological changes in CKD. Calculation of the w-KL/H index may be of help as a non-invasive tool to identify patients with significant renal disease and might be useful to guide therapeutic decisions.

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“…2a . Echogenicity was measured according to prior reported method [ 10 – 12 ]. A contrast enhanced ultrasound was performed displaying a distinct different perfusion pattern of these two areas.…”

Section: Case Presentationmentioning

confidence: 99%

Two in One: Epithelioid angiomyolipoma within a classic kidney angiomyolipoma - a case report

et al. 2018

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BackgroundEpithelioid angiomyolipoma is defined as potentially malignant mesenchymal neoplasm, characterized by proliferating epithelioid cells, whereas classic angiomyolipoma, composed of fat, smooth muscle cells and dysmorphic vessels, is defined as a potentially benign. The usual or classic angiomyolipoma is often found incidentally on imaging studies, relatively easily identified due to the presence of fat, in contrast to the epithelioid angiomyolipoma that can pose diagnostic challenges.Case presentationWe report a 51-year-old female patient in which an ultrasonography examination showed a solid mass close to the right renal pelvis with hypoechoic and hyperechoic areas. A differential diagnosis of atypical sinus lipomatosis, lipoma and a transitional cell carcinoma was postulated whereas in a subsequent computed tomography a classic angiomyolipoma was postulated. A re-examination by contrast enhanced ultrasound revealed a striking perfusion difference of the hypoechoic and hyperechoic areas. The hypoechoic area showed homogenous and prolonged enhancement whereas the hypoechoic area displayed a marked slower contrast material flooding and a relatively rapid wash out. The histological analysis from the biopsy of the hyperechoic area showed a classic angiomyolipoma, whereas the sample of the hypoechoic central portion revealed an epithelioid angiomyolipoma. A nephrectomy was performed because of the malignant potential of the epithelioid variant of the angiomyolipoma.ConclusionsA solid kidney mass with two sharply defined parts, one-part compatible with a classical angiomyolipoma and the other being suspected of carcinoma, is rare, but also illustrative and instructive. The combination of different imaging modalities in the work up of a solid renal mass facilitated to discriminate benign from malignant areas.

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Die quantitative Messung der Echogenität des Nierenparenchyms

Cited by 8 publications

References 3 publications

Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure

Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure

Sonographically determined kidney measurements are better able to predict histological changes and a low CKD-EPI eGFR when weighted towards cortical echogenicity

Two in One: Epithelioid angiomyolipoma within a classic kidney angiomyolipoma - a case report

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