دورية أكاديمية
Prediction of acute rejection in renal allografts using shear-wave dispersion slope.
| العنوان: | Prediction of acute rejection in renal allografts using shear-wave dispersion slope. |
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| المؤلفون: | Kim TM; Department of Radiology, Seoul National University Hospital, Seoul, South Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea., Ahn H; Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea.; Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea., Cho JY; Department of Radiology, Seoul National University Hospital, Seoul, South Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea., Han A; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea., Min SI; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea., Ha J; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea., Kim SY; Department of Radiology, Seoul National University Hospital, Seoul, South Korea. iwishluv@empas.com.; Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea. iwishluv@empas.com. |
| المصدر: | European radiology [Eur Radiol] 2024 Jul; Vol. 34 (7), pp. 4527-4537. Date of Electronic Publication: 2023 Dec 13. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1991- |
| مواضيع طبية MeSH: | Graft Rejection*/diagnostic imaging , Kidney Transplantation* , Elasticity Imaging Techniques*/methods, Humans ; Male ; Middle Aged ; Female ; Adult ; Retrospective Studies ; Biopsy ; Kidney/diagnostic imaging ; Kidney/pathology ; Allografts ; Predictive Value of Tests |
| مستخلص: | Objectives: To evaluate the role of shear-wave dispersion slope for predicting renal allograft dysfunction. Methods: We retrospectively reviewed 128 kidney transplant recipients (median age, 55 years [interquartile range, 43-62 years]; male, 68) who underwent biopsy for allograft evaluation from November 2022 to February 2023. Cortex and renal sinus fat stiffness and shear-wave dispersion slope were obtained at shear-wave elastography (SWE). Cortex-to-sinus stiffness ratio (SR) and dispersion slope ratio (DSR)-related clinical and pathologic factors were evaluated using multivariable linear regression analysis. We conducted univariate and multivariate analyses for multiparametric ultrasound (US) parameters for identifying acute rejection and calculated the area under the receiver operating curve (AUC) values. Results: Of 128 patients, 31 (24.2%) demonstrated acute rejection. The SR value did not differ between patient groups (1.21 vs. 1.20, p = 0.47). Patients with acute rejection demonstrated a higher DSR than those without rejection (1.4 vs. 1.21, p < 0.01). Interstitial fibrosis and tubular atrophy grade (IFTA; coefficient, 0.11/grade; p = 0.04) and renal transplant and biopsy interval (coefficient, 0.00007/day; p = 0.03) were SR determinant factors, whereas only IFTA grade (coefficient, 0.10/grade; p = 0.01) for DSR. Multivariate analysis revealed mean resistive index (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.02-1.14, p = 0.01) and DSR value (OR 16.0, 95% CI 3.0-85.8, p = 0.001) as independent factors for predicting acute rejection. An AUC of 0.74 for detecting acute rejection was achieved by combining the resistive index and DSR value. Conclusion: Shear-wave dispersion slope obtained at SWE may help identify renal allograft dysfunction. Clinical Relevance Statement: Acute rejection in renal allografts is a major cause of allograft failure, but noninvasive diagnosis is a challenge. Shear-wave dispersion slope can identify acute rejection non-invasively. Key Points: • The interstitial fibrosis and tubular atrophy grade was a determinant factor for stiffness ratio and shear-wave dispersion slope ratio between cortex and renal sinus fat. • Shear-wave dispersion slope ratio between cortex and renal sinus fat could identify acute rejection in renal allografts. • A shear-wave dispersion slope has a potential to reduce unnecessary renal biopsy for evaluating renal allografts. (© 2023. The Author(s), under exclusive licence to European Society of Radiology.) |
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| فهرسة مساهمة: | Keywords: Acoustic radiation force impulse imaging; Graft rejection; Kidney transplantation; Sonoelastography; Viscosity |
| تواريخ الأحداث: | Date Created: 20231213 Date Completed: 20240628 Latest Revision: 20240712 |
| رمز التحديث: | 20240712 |
| DOI: | 10.1007/s00330-023-10492-8 |
| PMID: | 38091056 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-1084 |
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| DOI: | 10.1007/s00330-023-10492-8 |