title: Acoustic radiation force impulse (ARFI) elastography for detection of renal damage in children.
abstract: BACKGROUND
  Acoustic radiation force impulse (ARFI) imaging is a promising method for noninvasive evaluation of the renal parenchyma.
  
  
  OBJECTIVE
  To investigate the contribution of ARFI quantitative US elastography for the detection of renal damage in kidneys with and without vesicoureteral reflux (VUR).
  
  
  METHODS
  One hundred seventy-six kidneys of 88 children (46 male, 42 female) who had been referred for voiding cystourethrography and 20 healthy controls were prospectively investigated. Patients were assessed according to severity of renal damage on dimercaptosuccinic acid (DMSA) scintigraphy. Ninety-eight age- and gender-matched healthy children constituted the control group. Quantitative shear wave velocity (SWV) measurements were performed in the upper and lower poles and in the interpolar region of each kidney. DMSA scintigraphy was performed in 62 children (124 kidneys). Comparisons of SWV values of kidneys with and without renal damage and/or VUR were done.
  
  
  RESULTS
  Significantly higher SWV values were found in non-damaged kidneys. Severely damaged kidneys had the lowest SWV values (P < 0.001). High-grade (grade V-IV) refluxing kidneys had the lowest SWV values, while non-refluxing kidneys had the highest values (P < 0.05). Significant negative correlations were found between the mean quantitative US elastography values and DMSA scarring score (r = -0.788, P < 0.001) and VUR grade (r = -0.634, P < 0.001). SWV values of the control kidneys were significantly higher than those of damaged kidneys (P < 0.05).
  
  
  CONCLUSIONS
  Our findings suggest decreasing SWV of renal units with increasing grades of vesicoureteric reflux, increasing DMSA-assessed renal damage and decreasing DMSA-assessed differential function.
authors: Department of Radiology Medical School, Dicle University, Diyarbakir, Turkey.
authors: Cemil
authors: C
authors: Göya
authors: Cihad
authors: C
authors: Hamidi
authors: Aydın
authors: A
authors: Ece
authors: Mehmet Hanifi
authors: MH
authors: Okur
authors: Bekir
authors: B
authors: Taşdemir
authors: Mehmet Güli
authors: MG
authors: Çetinçakmak
authors: Salih
authors: S
authors: Hattapoğlu
authors: Memik
authors: M
authors: Teke
authors: Cahit
authors: C
authors: Şahin
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging*