Sonographic Prediction of Pediatric Renal Scarring With Full Parameter Normalization.
OBJECTIVE
To predict the chronic kidney disease (CKD) state for pediatric patients based on scaled renal cortical echogenicity.


METHODS
Sonograms from a cohort of 26 patients, half of whom had stage 4 or 5 CKD, whereas the other half had normal renal function, were analyzed. For each patient image, a region of interest (ROI) was drawn around the renal cortex for comparison with an ROI drawn around the hepatic parenchyma. The latter ROI was shifted spatially to normalize the signal attenuations and time-gain compensations of the two organs' ROIs. Then the average pixel intensity of the renal ROI was divided by the corresponding hepatic value, resulting in scaled renal cortical echogenicity.


RESULTS
The average scaled renal cortical echogenicity was higher for diseased than healthy kidneys by roughly a factor of 2 (2.01 [95% confidence interval, 1.62-2.40] versus 1.05 [95% confidence interval, 0.88-1.23] for normal kidneys). This difference was statistically significant (P < .001).


CONCLUSIONS
Our results show that the pediatric CKD state correlates with rigorously calculated scaled renal cortical echogenicity.
Department of Radiology, Columbia University Medical Center, New York, New York USA jns2001@nyp.org.
Joseph N
JN
Stember
Department of Radiology, Columbia University Medical Center, New York, New York USA.
Dustin
D
Lynch
Department of Radiology, Columbia University Medical Center, New York, New York USA.
Gerald
G
Behr
Department of Urology, Columbia University Medical Center, New York, New York USA.
Shumyle
S
Alam
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
echogenicity; genitourinary ultrasound; pediatric; renal cortical scarring