Diagnostic value of real-time shear wave elastography in children with chronic kidney disease
1Ultrasound Department, Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Insights
Real-time shear wave elastography (SWE) shows increased kidney stiffness in children with chronic kidney disease (CKD). This technique may aid in early CKD diagnosis and monitoring disease progression.
Area of Science:
- Pediatric Nephrology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Chronic kidney disease (CKD) in children poses significant health challenges.
- Accurate diagnostic tools are crucial for managing pediatric CKD.
- Real-time shear wave elastography (SWE) offers a non-invasive method to assess tissue stiffness.
Purpose of the Study:
- To evaluate the diagnostic value of real-time shear wave elastography (SWE) for detecting chronic kidney disease (CKD) in children.
- To assess the correlation between renal stiffness measured by SWE and CKD progression.
Main Methods:
- Children with biopsy-confirmed CKD were compared to age- and sex-matched healthy controls.
- Renal cortex stiffness, measured as Young's Modulus (YM) using SWE, was assessed.
- Statistical analyses, including variance analysis and ROC curve analysis, were performed.
Main Results:
- Children with CKD exhibited significantly higher kidney Young's Modulus (YM) compared to healthy controls (P < 0.001).
- Renal YM values increased with CKD progression.
- Optimal cut-off values for diagnosing CKD using left and right kidney YM were determined with high sensitivity and specificity.
Conclusions:
- Increased renal YM is associated with CKD progression in children.
- SWE shows promise as a novel method for early CKD diagnosis in pediatric patients.
- This technique may facilitate dynamic monitoring of disease progression and treatment efficacy.
Objective:
To evaluate the diagnostic value of real-time shear wave elastography (SWE) in children with chronic kidney disease (CKD).
Methods:
Children with CKD diagnosed by the ultrasound-guided biopsy between January 2018 and May 2019 were enrolled as the case group. Age- and sex- matched healthy children were selected as the control group. The Young's Modulus (YM) of the renal cortex was measured by SWE after the traditional ultrasound examination. Variance analysis was performed to compare the values of YM between the two groups. Receiver operating characteristic curve (ROC) analysis was used to compare the values of YM, and explore the cut-offs of the YM.
Results:
In the case group (n = 60, 45% male, mean age of 9.2 years), the kidney YM modulus on the left side (16.8±4.8 kPa vs. 8.3±2.1 kPa) and the right side (16.0±4.7 kPa vs. 8.3±2.4 kPa) were both higher than the control group (all P values < 0.001). With the progress of CKD, the YM value of the left and right kidneys gradually increased. ROC analysis showed that when the left and right kidney YM value was 11.7 kPa and 11.0 kPa, the diagnostic sensitivity and specificity were the highest (left: respectively 93.3% and 95.0%; right: respectively 93.3 % and 91.7%).
Conclusion:
The increase of YM in CKD is related to the progression of renal dysfunction which may provide a new method for early diagnosis of CKD, dynamic monitoring of disease progression, and evaluation of curative effect and prognosis.
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