scholarly journals Renal Acoustic Radiation Force Impulse Elastography in Hypertensive Nephroangiosclerosis Patients

2021 ◽  
Vol 11 (22) ◽  
pp. 10612
Author(s):  
Alexandru Caraba ◽  
Andreea Munteanu ◽  
Stela Iurciuc ◽  
Mircea Iurciuc
Keyword(s):  
Acoustic Radiation ◽  
Resistive Index ◽  
Radiation Force ◽  
Cross Sectional Study ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio ◽  
Diagnosis Method ◽  
New Diagnosis

Objective: Hypertensive nephroangiosclerosis (HN) represents the second most common cause of chronic kidney disease. Kidney damage secondary to high blood pressure favors the appearance of serum and urinary changes, but also imaging, highlighted by ultrasonography (B-mode, Doppler, Acoustic Radiation Force Impulse Elastography). Acoustic Radiation Force Impulse Elastography (ARFI) represents a new imagistic method which characterizes renal stiffness in the form of shear wave velocity (SWV). Aim: This study aims to investigate renal stiffness in HN patients, and to assess the correlations between it and urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and intrarenal resistive index (RRI). Material and Methods: This cross-sectional study was performed on a group of 80 HN patients and 50 healthy, sex and age-matched, as controls. UACR (urinary immunoturbidimetry), eGFR (Jaffe method), RRI, and renal SWV (Siemens Acuson 2000) were determined in all patients and controls. Data were expressed as mean ± standard deviation. Statistical analysis was done by means Pearson’s test and t-Student test, p values of less than 0.05 were considered statistically significant. Results: UACR, eGFR, RRI and SWV showed statistically significant differences between the HN patients and controls (p < 0.0001). In the hypertensive patients group, statistically significant correlations were observed between the SWV and UACR (r = −0.7633, p < 0.00001), eGFR (r = 0.7822, p = 0.00001), and RRI (r = −0.7978, p = 0.00001). Conclusions: Kidney sonoelastography characterizes imagistically the existence of intrarenal lesions associated with essential hypertension, offering a new diagnosis method for these patients.

scholarly journals Acoustic radiation force impulse (ARFI) elastography compared with biopsy for evaluating hepatic fibrosis after liver transplantation: a cross-sectional diagnostic study

2016 ◽  
Vol 134 (6) ◽  
pp. 513-518 ◽  
Author(s):  
Joel Schmillevitch ◽  
◽  
Maria Cristina Chammas ◽  
Vincenzo Pugliese ◽  
Edson Abdala ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Diagnostic Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Arfi Elastography

ABSTRACT CONTEXT AND OBJECTIVE: Biopsies are used after liver transplantation to evaluate fibrosis. This study aimed to evaluate the elasticity of transplanted livers by means of a non-invasive examination, acoustic radiation force imaging (ARFI) elastography, correlating the results with the histological analysis. DESIGN AND SETTING: Cross-sectional study in a public university hospital. METHODS: All patients consecutively operated between 2002 and 2010 with an indication for biopsy were evaluated by means of elastography. The radiologist evaluating ARFI and the pathologist doing anatomopathological examinations were blinded to each other's evaluations. RESULTS: During the study period, 33 patients were included. The indication for transplantation was cirrhosis due to hepatitis C in 21 cases (63%). Liver biopsies showed absence of fibrosis (F0) in 10 patients, F1 in 11, F2 in 8 and F3 in 4. There were no cases of F4 (cirrhosis). The difference in ARFI values (degree of fibrosis) was 0.26 (95% confidence interval, CI: 0.07-0.52) between the groups F0-F1 and F2-F4 (P = 0.04). An area under the curve of 0.74 (CI: 0.55-0.94) and a cutoff of 1.29 m/s between the groups resulted in the best relationship between sensitivity and specificity. Sensitivity (0.66; CI: 0.50-0.83) was lower than specificity (0.85; CI: 0.72-0.97). There was no significant difference in ARFI between patients with hepatitis C and those with other diseases. CONCLUSIONS: The values obtained from elastography were not affected by inflammatory reaction or anatomical alterations. A cutoff point of 1.29 m/s separating patients with or without significant fibrosis was identified.

scholarly journals Acoustic Radiation Force Impulse (ARFI) elastography imaging of equine distal forelimb flexor structures

2020 ◽  
Vol 72 (4) ◽  
pp. 1154-1162
Author(s):  
N.S. Bernardi ◽  
M.A.R. Feliciano ◽  
K. Gravena ◽  
M.L. Avante ◽  
A.P.R. Simões ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Cross Sectional ◽  
Suspensory Ligament ◽  
Superficial Digital Flexor Tendon ◽  
Arfi Elastography ◽  
Sectional Plane

ABSTRACT This study set out to determine normal values for acoustic radiation force impulse (ARFI) elastography of the superficial digital flexor tendon, deep digital flexor tendon, accessory ligament of the deep digital flexor tendon and suspensory ligament in horses. Twenty-four horses were submitted to conventional sonographic assessment and elastography imaging (quantitative ARFI method) of distal forelimb tendons and ligaments at nine anatomical regions. Elastograms depicted tendons and ligaments in orange to red tones consistent with greater stiffness. Shear wave velocity was higher in the longitudinal compared to the cross-sectional plane but did not differ significantly between the left and right forelimbs. The suspensory ligament was stiffer compared to remaining structures in the cross-sectional plane. Ligaments were stiffer than tendons and the deep digital flexor tendon was stiffer than the superficial digital flexor tendon in the longitudinal plane. Target structures were stiffer in male compared to female horses and stiffness tended to increase with age. ARFI elastography proved to be a feasible and reproducible imaging modality for assessment of distal forelimb tendons and ligaments in horses. Qualitative features derived from stiffness quantification in these structures can be applied to horses with musculoskeletal disorders, as well as to other animal species.

Acoustic radiation force impulse imaging for detection of liver fibrosis in overweight and obese children

2017 ◽  
Vol 59 (2) ◽  
pp. 247-253 ◽  
Author(s):  
Juan D Berná-Serna ◽  
Regina Sánchez-Jiménez ◽  
Francisca Velázquez-Marín ◽  
Pilar Sainz de Baranda ◽  
Florentina Guzmán-Aroca ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Normal Liver ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Obese Children ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Laboratory Parameters

Background Acoustic radiation force impulse (ARFI) is a non-invasive alternative to a liver biopsy for the evaluation of liver fibrosis (LF). Purpose To investigate the potential usefulness of acoustic radiation force impulse ARFI for detecting LF in overweight and obese children Material and Methods A cross-sectional study was conducted in 148 schoolchildren. A diagnosis of non-alcoholic fatty liver disease (NAFLD) and LF was based on ultrasound (US) and ARFI shear wave velocity (SWV). Results The laboratory parameters were normal in all the children. NAFLD was observed in 50 children (33.8%). The median SWV was 1.18 ± 0.28 m/s. Differences between ARFI categories and hepatic steatosis grades were observed (χ2 = 43.38, P = 0.0005). No fibrosis or insignificant fibrosis (SWV ≤ 1.60 m/s) was detected in 137 children (92.5%), and significant fibrosis (SWV > 1.60 m/s) in 11 children (7.5%), nine of whom had normal US or mild steatosis. Conclusion The present study is the first to evaluate the utility of the ARFI technique for detecting LF in overweight and obese children. The results of the study suggest that children with normal laboratory parameters such as normal liver ultrasound or mild steatosis may present with significant LF.

Rationale Abklärung von Lebererkrankungen

2017 ◽  
Vol 74 (3) ◽  
pp. 79-86
Author(s):  
Leona von Köckritz ◽  
Andrea De Gottardi
Keyword(s):  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Alkalische Phosphatase ◽  
Gamma Glutamyltransferase ◽  
Alpha 1 Antitrypsin

Zusammenfassung. Im klinischen Alltag werden häufig erhöhte Leberwerte beobachtet. In der Regel erfordern sie weitere Abklärungen bezüglich der möglichen Ätiologie und des Schweregrad einer akuten oder chronischen Lebererkrankung. Die Abklärung sollte dabei neben einer gezielten Anamnese und sorgfältigen klinischen Untersuchung, auch die Bestimmung von laborchemischen Markern für Cholestase und Leberfunktionsstörungen (wie Alkalische Phosphatase, gamma-Glutamyltransferase, Bilirubin, Albumin und Gerinnungsfaktoren) umfassen. Die Bestimmung weiterer Parameter wie Ferritin und Transferrinsättigung, Autoimmunantikörper, Virusserologien, alpha-1 Antitrypsin und Coerulolasmin können weitere Hinweise für die kausalen Zusammenhänge der Leberfunktionsstörung liefern. Bei Patienten mit Lebererkrankungen ist eine sonografische Beurteilung der Leber obligat. Ergänzend zur Sonografie werden heute weitere nicht-invasive Methoden wie Fibroscan, Acoustic Radiation Force Impulse Elastometrie und Magnet-Resonanz-Elastografie zur Beurteilung der Leberfibrose eingesetzt. In ausgewählten Fällen ist eine Leberbiopsie notwendig, um den Grad der Fibrose und die Ätiologie der Lebererkrankung zu eruieren. Mithilfe eines Fallbeispiels, diskutieren die Autoren im Folgenden die rationale Anwendung diagnostischer Tests und deren korrekte Interpretation und schlagen eine Orientierungshilfe zur rationalen Abklärung von Patienten mit Lebererkrankungen vor.

Neue Horizonte bei der Lebersonographie

Praxis ◽  
2012 ◽  
Vol 101 (18) ◽  
pp. 1161-1166
Author(s):  
Hagara ◽  
Schwarzenbach ◽  
Cerny
Keyword(s):  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse

Dank technologischer Verbesserungen und einer immer besser werdenden klinischen Evidenzlage wird der diagnostische Ultraschall im Vergleich zu den Röntgen- und Magnetresonanzverfahren vermehrt eingesetzt. Dies nicht nur aus Kostengründen, sondern auch um der Zunahme der Strahlenbelastung der Bevölkerung durch diagnostische ionisierende Strahlen entgegenzuwirken. In der folgenden Übersichtsarbeit versuchen die Autoren die neuesten Entwicklungen im Bereich des Leberultraschalls vorzustellen. Bemerkenswert sind Verfahren, die eine dynamische Untersuchung der Leberdurchblutung mittels Kontrastmittelultraschall (Schwefelhexafluorid SonoVue®) und damit Verbesserungen bei der Charakterisierung von fokalen Leberläsionen wie Metastasen extrahepatischer Tumoren, Regeneratsknoten bei Leberzirrhose, fokaler nodulärer Hyperplasie, hepatozellu-lärem Karzinom, Leberhämangiom, Leberadenom sowie fokaler Mehr- oder Minderverfettung ermöglichen. Ebenfalls wichtig sind Techniken, die eine Bestimmung der Gewebekonsistenz mittels transienter Elastographie (Fibroscan), ARFI (Acoustic Radiation Force Impulse) oder Echtzeit-Gewebe-Elastographie erlauben. Die Quantifizierung des Steatosegrads ist für Diagnose und Verlaufsbeurteilung von Leberpathologien unabdingbar.

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