대한신장학회

논문분류	춘계학술대회 초록집
제목	Comparison of Shear Elastography with Strain Elastography in imaging Renal Transplant Kidney
저자	Karthik Balasubramaniam, Balasubramaniam Jeyaraj, Murugesan AG, Alex Babu JM, Dhivya Balasubramaniam
출판정보	2020; 2020(1):
키워드	Renal Transplantation \| USG Imaging \| Elastography
초록	Elastography is emerging as a new tool for assessing transplant kidney. Usefulness of it in in evaluating graft dysfunction and fibrosis is still controversial. AIM: To compare Shear and Strain Elastography in imaging renal transplant kidney. METHODS: Stable Transplant recipients were imaged by single examiner using GE/USG machine. Sick, obese and those with skin to kidney depth above 3 cm were excluded. Mean of multiple readings from different regions were taken. Sinus tissue value taken as baseline for Strain readings. Unreliable Shear readings (IQR/MED >30) were discarded. Statistical methods using SPSS software applied to study correlations and significance. RESULTS: 47 patients aged 7 to 71 yrs; post transplant duration 15 days to 3 yrs; creatinine 0.9 to 11 were studied. Readings ranged from 0.9 to 8.7 by Strain and 4.5 to 40 kpa by Shear elastography. DISCUSSION: Elastography estimates the stiffness/elasticity of tissues. Useful in differentiating benign from malignant mass lesions in superficial organs like breast, thyroid and prostate. Transplant kidneys placed superficially (unlike native kidneys) are amenable for elastography. Literature quotes usefullness in assessing fibrosis and differentiating causes of graft dysfuntion in transplant kidneys. Renal structure being heterogenous with cortex, medulla, pyramids, vessels and calyces does not lend itself easily for interpretation by elastography. Presence of multiple elastography techniques like strain, shear, transient, futher compound the confusion. Although there was positive correlation between strain and shear, it was weak(Pearson correlation- 0.10). 19 out of 47 studies had unsatisfactory Shear readings. Although Shear technique is recent, is not as reliable as Strain elastography. More technical refining is warrented. CONCLUSIONS: 1. Stiffness of kidney measured by Strain and Shear elastography show only weak positive correlation. 2. No correlation between serum creatinine, post transplant duration and elastography. 3. Shear elastography with more variable and unreliable readings appear less reliable than Strain.
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