Ultrasound Viscoelastic Imaging for Pediatric Henoch-Schönlein Purpura Nephritis: A Noninvasive Approach for...

This study aimed to evaluate the feasibility of ultrasound viscoelastic imaging for assessing Henoch-Schönlein purpura nephritis (HSPN) in children and to explore the correlation between viscosity parameters and inflammatory activity.

In this retrospective study, we initially collected data from 190 children diagnosed with Henoch-Schönlein purpura (HSP). After applying inclusion and exclusion criteria, 169 patients were finally enrolled, comprising 80 cases of HSP and 89 cases of HSPN confirmed by renal biopsy. All participants underwent ultrasound viscoelastic examination, and their clinical characteristics and laboratory data were recorded.

The results demonstrated that ultrasound viscoelastic imaging exhibited excellent diagnostic performance for HSPN, with the area under the curve (AUC) values of 0.91, 0.84, and 0.83 for renal cortical elasticity (Emean), viscosity coefficient (Vmean), and dispersion coefficient (Dmean), respectively. The diagnostic efficacy was further improved when these parameters were combined (AUC = 0.95). Multivariate logistic regression analysis identified Emean, Vmean, urinary white blood cell count, and serum albumin as independent predictors of HSPN. Notably, the HSPN group showed significantly higher age and body mass index (BMI) compared to the HSP group. Importantly, viscosity parameters (Vmean) demonstrated significant correlations with white blood cell count (WBC; r = 0.238, p = .002) and albumin levels (r = -0.274, p < .001), suggesting its favorable sensitivity in reflecting inflammatory activity. However, its ability to differentiate between pathological subtypes of HSPN remains limited.

Ultrasound viscoelastic imaging represents a novel, noninvasive modality with potential value in identifying HSPN. Vmean showed greater sensitivity in assessing inflammatory activity.