Comparison of Doppler Ultrasonography and Shear Wave Elastography Findings with Pathology Results of Patients with Nephropathy

Abstract

Regular screening and evaluation of diabetic patients eliminates the need for biopsy in many patients, and generally only patients with atypical manifestations of kidney disease need biopsy. The aim of this study is to comparison of Doppler ultrasonography and shear wave elastography findings with pathology results of patients with nephropathy. Materials and Methods: This research was a descriptive-analytical cross-sectional study and taking into account the inclusion and exclusion criteria, 85 patients with unexplained nephropathy who were admitted to Imam Reza Hospital in Tabriz between October 2020 and October 2021, were randomly selected using Rand list version 1.2 software. Basic information, including demographic information, was recorded in the relevant checklist. Then the patients were evaluated with gray scale ultrasound, and kidney size, parenchyma size, parenchyma echo, corticomedullary differentiation, kidney boundaries and the presence of hydronephrosis in the kidney were evaluated. Then the patients were subjected to Doppler ultrasound and SWE (using supersonic magic and broadband curvilinear transducer) and Resistance Index (RI), Pulsatility Index (PI), Peak Systolic Velocity (PSV) and parenchymal elastography were determined. Also, the level of the patients' tests, including urea, creatinine and urinary sodium of the patients, were also recorded. Patients were followed up after the biopsy in terms of pathology results. Results: In this study, parenchymal echo was increased in 18 cases (21.2%) of these people. Also, corticomedullary differentiation was lost in 2 cases (2.4%) of the studied subjects and was evident in 9 cases (10.6%). There was mild hydronephrosis in 2 cases (2.4%) of the studied subjects. Also, UA protein was negative in 8 cases (9.4%), mild in 23 cases (27.1%), moderate in 48 cases (56.4%), and severe in 6 cases (7.1%). There were also UA RBC in 25 cases (29.4%), UA WBC in 20 cases (23.5%), and UTI in 15 cases (17.6%). The mean (standard deviation) of elastography in the studied subjects was 5.33 (±3.5). Also, the mean (SD) of RI and PI in these people was 0.67 (±0.2) and 1.15 (±0.4), respectively. The most pathological findings in the studied subjects were, respectively, Membranous glomerulopathy with 19 cases (22.4%), FSGN & Sclerosis with 15 cases (17.6%), and Minimal histologic abnormalities and Diabetes each with 11 cases (12.9%). In this study, among the findings of Shear wave elastography, RI and PI values of Doppler ultrasound, none of them had a statistically significant relationship with the results of pathology in the studied patients with nephropathy (P-value>0.05).