title: Acoustic radiation force impulse (ARFI) in the evaluation of the renal parenchymal stiffness in paediatric patients with vesicoureteral reflux: preliminary results.
abstract: OBJECTIVE
  To prospectively evaluate acoustic radiation force impulse (ARFI) imaging of the kidneys in children with and without chronic renal disease.
  
  
  METHODS
  Twenty-eight children (age range 9-16 years) with primary or secondary vesicoureteral reflux (≥ grade III) underwent scintigraphy and ultrasound with ARFI. Kidneys were divided-according to scintigraphy-into "affected" and "contralateral"; the results were compared with 16 age-matched healthy subjects. An ARFI value, expressed as speed (m/s) of wave propagation through the tissue, was calculated for each kidney through the mean of the values obtained at the upper, middle and lower third. The Wilcoxon test was used; P values <0.05 were considered statistically significant.
  
  
  RESULTS
  The mean ARFI values obtained in the "affected" kidneys (5.70 ± 1.71 m/s) were significantly higher than those measured in both "contralateral" (4.09 ± 0.97, P < 0.0001) and "healthy" kidneys (3.13 ± 0.09, P < 0.0001). The difference between values in the "contralateral" kidneys and "healthy" ones was significant (P < 0.0001). The "affected" kidneys with secondary reflux had mean ARFI values (6.59 ± 1.45) significantly higher than those with primary reflux (5.35 ± 1.72).
  
  
  CONCLUSIONS
  ARFI values decrease from kidneys with secondary vesicoureteral reflux to kidneys with primary reflux to unaffected kidneys contralateral to reflux to normal kidneys.
authors.affiliation: Department of Radiology, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy, costanza_bruno@libero.it.
authors.forename: Costanza
authors.initials: C
authors.lastname: Bruno
authors.forename: Giuliana
authors.initials: G
authors.lastname: Caliari
authors.forename: Marco
authors.initials: M
authors.lastname: Zaffanello
authors.forename: Milena
authors.initials: M
authors.lastname: Brugnara
authors.forename: Michele
authors.initials: M
authors.lastname: Zuffante
authors.forename: Mariangela
authors.initials: M
authors.lastname: Cecchetto
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minniti
authors.forename: Alice
authors.initials: A
authors.lastname: Pedot
authors.forename: Giorgio
authors.initials: G
authors.lastname: Talamini
authors.forename: Roberto
authors.initials: R
authors.lastname: Pozzi-Mucelli
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D019783:Technetium Tc 99m Dimercaptosuccinic Acid