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Shear wave elastography accurately detects chronic changes in renal histopathology
Author(s) -
Leong Sook Sam,
Wong Jeannie Hsiu Ding,
Md Shah Mohammad Nazri,
Vijayananthan Anushya,
Jalalonmuhali Maisarah,
Chow Tak Kuan,
Sharif Nur H. M.,
Ng Kwan Hoong
Publication year - 2021
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13805
Subject(s) - medicine , elastography , renal biopsy , receiver operating characteristic , kidney disease , urology , fibrosis , glomerulosclerosis , pathology , biopsy , histopathology , kidney , radiology , ultrasound , proteinuria
Aim Renal biopsy is the gold standard for the histological characterization of chronic kidney disease (CKD), of which renal fibrosis is a dominant component, affecting its stiffness. The aim of this study was to investigate the correlation between kidney stiffness obtained by shear wave elastography (SWE) and renal histological fibrosis. Methods Shear wave elastography assessments were performed in 75 CKD patients who underwent renal biopsy. The SWE‐derived estimates of the tissue Young's modulus (YM), given as kilopascals (kPa), were measured. YM was correlated to patients' renal histological scores, broadly categorized into glomerular, tubulointerstitial and vascular scores. Results Young's modulus correlates significantly with tubulointerstitial score ( ρ = 0.442, P < .001) and glomerular score ( ρ = 0.375, P = .001). Patients with no glomerular sclerosis showed lower mean YM measurements compared to those with glomerular sclerosis. The mean YM increased as the percentage of interstitial fibrosis and tubular atrophy increased. The area under the receiver operating characteristic curve (ROC) for SWE in differentiating between mildly and moderately impaired kidneys was 0.702. Conclusion Shear wave elastography accurately detects chronic renal damage resulting from glomerular sclerosis, interstitial fibrosis and tubular atrophy, using the optimal cut‐off YM value of ≥5.81 kPa.