Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease

Abstract

Purpose To evaluate the value of multiparametric quantitative ultrasound imaging (QUI) in assessing chronic kidney disease (CKD) using kidney biopsy pathology as the reference standard. Methods We prospectively measured multiparametric QUI markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with CKD prior to their kidney biopsies and in 10 healthy volunteers. Based on all pathology (glomerulosclerosis, IF/TA, arteriosclerosis, and edema) scores, the 25 CKD patients were classified into mild (no grade 3 and < 2 of grade 2) and moderate to severe (at least 2 of grade 2 or 1 of grade 3) CKD groups. Multiparametric QUI in the study included kidney length, cortical thickness, pixel-intensity, parenchymal shear wave velocity (SWV), intrarenal artery peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI). We tested the difference in QUI parameters among mild CKD, moderate to severe CKD, and healthy controls using ANOVA, analyzed correlations of QUI parameters to kidney pathology scores and to eGFR using the Pearson correlation coefficient, and examined the diagnostic performance of QUI parameters in determining moderate CKD and eGFR <60 using ROC curve analysis. Results There were significant differences in cortical thickness, pixel-intensity, PSV, and EDV among the 3 groups (all p< 0.01). Among QUI parameters, the top AUROCs of PSV and EDV for determining pathologic moderate to severe CKD were 0.88 and 0.97, and for eGFR <60 were 0.76 and 0.86, respectively. Moderate to good correlations were found for PSV, EDV, and pixel-intensity to pathology score and eGFR. Conclusion PSV, EDV, and pixel-intensity are valuable in determining moderate to severe CKD. The value of SWV in assessing CKD needs further investigation.

The Value of Contrast-Enhanced Ultrasound versus Doppler Ultrasound in Grading Renal Artery Stenosis

“…DUS has been the first-line imaging modality for the diagnosis of renal artery stenosis [ 33 , 34 ]. It permits the grading of renal artery stenosis by using hemodynamic measurement parameters [ 35 ]. However, the results of DUS in different studies are to some extent conflicting [ 24 , 35 ].…”

“…It permits the grading of renal artery stenosis by using hemodynamic measurement parameters [ 35 ]. However, the results of DUS in different studies are to some extent conflicting [ 24 , 35 ]. Advanced imaging technique such as CEUS has attracted the attention of researchers [ 17 , 24 , 25 ].…”

Using Ultra-Sonography in Acute and Chronic Renal Pathologies: A Cross-Sectional Study

“…There have also been many attempts to determine the type of kidney involvement according to the ultrasound findings. For example, decreased renal cortex thickness and decreased renal size may be caused by tubular atrophy (8). Unfortunately, our understanding regarding the significance of renal cortical thickness and the association between renal size and renal parenchymal disorders is limited.…”

Can distinction between the renal cortex and outer medulla on ultrasonography predict estimated glomerular filtration rate in canine chronic kidney diseases?

“…The authors also note that quantitative evaluation of kidney using imaging modalities has been studied and developed in human [ 10 11 12 13 14 15 ]. Quantitative assessment of the kidney is helpful in diagnosing or evaluating the prognosis of chronic kidney disease (CKD) patients in humans.…”