US time-harmonic elastography for the early detection of glomerulonephritis

Grossmann M, Tzschaetzsch H, Lang ST, Guo J, Bruns A, Duerr M, Hoyer BF, Grittner U, Lerchbaumer M, Manh Nguyen Trong , Schultz M, Hamm B, Braun J, Sack I, Garcia SRM (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Radiology Radiological Society of North America (RSNA)

Book Volume: 292

Pages Range: 676-684

Journal Issue: 3

DOI: 10.1148/radiol.2019182574

Abstract

Background: Glomerulonephritis refers to renal diseases characterized by glomerular and tubulointerstitial fibrosis. Multifrequency US time-harmonic elastography enables the noninvasive quantification of tissue elasticity. Purpose: To assess the diagnostic performance of US time-harmonic elastography for the early detection of glomerulonephritis. Materials and Methods: From August 2016 through May 2017, study participants with biopsy-proven glomerulonephritis were prospectively examined with US time-harmonic elastography. Participants were subdivided according to chronic kidney disease (CKD) stage. All participants underwent elastography of both kidneys to generate full-field-of-view maps of renal shear wave speed (SWS). SWS was determined separately for the whole renal parenchyma, cortex, and medulla and was correlated with quantitative B-mode findings such as renal length and parenchymal thickness. Diagnostic performance of renal elastography was assessed with receiver operating characteristic curve analysis. Results: Fifty-three participants with glomerulonephritis (mean age ± standard deviation, 49 years ± 14) and 30 healthy volunteers (mean age, 37 years ± 11) were evaluated. Age-adjusted renal SWS was lower in participants with glomerulonephritis than in healthy volunteers in the parenchyma, cortex, and medulla, with mean values of 1.55 m/sec (95% confidence interval [CI]: 1.51 m/sec, 1.59 m/sec) and 1.69 m/sec (95% CI: 1.64 m/sec, 1.74 m/sec; P , .001), respectively, in parenchyma, 1.80 m/sec (95% CI: 1.75 m/sec, 1.84 m/sec) and 2.08 m/sec (95% CI: 2.02 m/sec, 2.13 m/sec; P , .001) in cortex, and 1.25 m/sec (95% CI: 1.21 m/sec, 1.29 m/sec) and 1.33 (95% CI: 1.27 m/sec, 1.38 m/sec; P = .03) in medulla. Age-adjusted renal cortex SWS was lower in participants with glomerulonephritis and stage 1 CKD (preserved renal function) than in healthy volunteers (mean, 1.88 [95% CI: 1.81, 1.96] vs 2.08 [95% CI: 2.02, 2.13]; P , .001). In participants with CKD, renal cortex SWS values showed a positive association with estimated glomerular filtration rate (n = 39; r = 0.56; P , .001). Exploratory diagnostic performance of US timeharmonic elastography (area under the receiver operating characteristic curve [AUC], 0.89; 95% CI: 0.82, 0.97) outperformed that of B-mode parameters such as parenchymal thickness (AUC, 0.64; 95% CI: 0.51, 0.77; P , .001) and renal length (AUC, 0.55; 95% CI: 0.40, 0.68; P , .001) in identifying glomerulonephritis. Conclusion: US time-harmonic elastography depicts abnormal renal stiffness in glomerulonephritis, particularly among patients with early disease and preserved renal function. Advanced chronic kidney disease is associated with further cortical softening. Timeharmonic elastography outperforms B-mode-based size quantification.

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) DE Germany (DE) GAMPT mbH DE Germany (DE)

How to cite

APA:

Grossmann, M., Tzschaetzsch, H., Lang, S.T., Guo, J., Bruns, A., Duerr, M.,... Garcia, S.R.M. (2019). US time-harmonic elastography for the early detection of glomerulonephritis. Radiology, 292(3), 676-684. https://doi.org/10.1148/radiol.2019182574

MLA:

Grossmann, Markus, et al. "US time-harmonic elastography for the early detection of glomerulonephritis." Radiology 292.3 (2019): 676-684.

BibTeX: Download