<strong>Introduction:</strong> In our practice, renal measurements in patients with normal renal function usually appear to be lower compared to standards reported in reference literature. The standards ar...<strong>Introduction:</strong> In our practice, renal measurements in patients with normal renal function usually appear to be lower compared to standards reported in reference literature. The standards are probably different in our context. Given the importance of renal biometrics in nephrological practice, we felt it necessary to carry out this preliminary study in order to identify an order of reference measurements appropriate to our context. <strong>Methods:</strong> This was a cross-sectional study that took place from 18 August to 04 November 2018 at the Yalgado Ouedrarogo University Hospital Center. The first 100 subjects aged between 18 and 30 years who met the following inclusion criteria were selected: to be black african Burkinabe and to have normal renal function. The height, width and thickness of each kidney were measured using ultra-sound scanners. For statistical tests, a value of p < 0.05 was considered statistically significant. <strong>Results:</strong> The average age was 23.9 ± 6.1 years and the sex ratio was 2.2. Mean heights, widths and renal thicknesses were 94.5 ± 14.5, 38.7 ± 10.7 and 36.3 ± 10.3 mm, and 96.7 ± 16.7, 42.7 ± 16.7 and 36.8 ± 10.8 mm respectively for right and left kidneys. The distribution of the different renal dimensions in our sample followed a normal distribution. In the particular case of the right kidney, the probability that its height was between 79.2 and 109.7 mm was 0.95 and the probability that it was less than 79.2 mm or greater than 109.7 mm was 0.05. Renal height was significantly higher in subjects with height greater than 1.70 m (p ≤ 0.02). The left kidneys were on average significantly larger than the right kidneys (p = 0.0001). <strong>Conclusions:</strong> Our study is not extrapolable to the general population of Burkina Faso. It suggests, however, that the kidneys of the apparently healthy Burkinabe subject are smaller than what is reported in anatomy reference books. Our work, which is preliminary, should be deepened through a national survey. In the meantime, we should consider, in the nephrological assessment of the Burkinabe patient, the results of the renal biometrics we report.展开更多
AIM:To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease(NAFLD)based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate.METHODS:A tota...AIM:To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease(NAFLD)based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate.METHODS:A total of 170 subjects were enrolled in this study.All subjects were examined by ultrasound and 1H-magnetic resonance spectroscopy(1H-MRS)on the same day.The ultrasound hepatic/renal echointensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program.RESULTS:Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with 1HMRS liver fat content(ultrasound hepatic/renal ratio:r=0.952,P=0.000;hepatic echo-intensity attenuation r=0.850,P=0.000).The equation for predictingliver fat content by ultrasound(quantitative ultrasound model)is:liver fat content(%)=61.519×ultrasound hepatic/renal ratio+167.701×hepatic echo-intensity attenuation rate-26.736.Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase,aspartate aminotransferase,and triglyceride,but negatively correlated with high density lipoprotein cholesterol.Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15%in the quantitative ultrasound model.Furthermore,in the quantitative ultrasound model,fatty liver diagnostic sensitivity and specificity were 94.7%and 100.0%,respectively,showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate.If the 1H-MRS liver fat content had a value<15%,the sensitivity and specificity of the ultrasound quantitative model would be 81.4%and 100%,which still shows that using the model is better than the other methods.CONCLUSION:The quantitative ultrasound model is a simple,low-cost,and sensitive tool that can accurately assess hepatic fat content in clinical practice.It provides an easy and effective parameter for the early diagnosis of mild hepatic steatosis and evaluation of the efficacy of NAFLD treatment.展开更多
Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less ...Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less comprehensively studied.Currently more than 50% of renal masses are incidentally diagnosed,mostly by B-mode ultrasound.The method of choice for characterization of renal lesions is contrast enhanced computed tomography(CECT).In the case of cystic lesions CECT refers to the Bosniak classification for cystic lesions to assess the risk of malignant behavior.The majority of masses are renal cell carcinoma,but the exact proportion is controversial.Disadvantages of CECT are a significant risk for patients with impaired renal function,allergic reactions and hyperthyroidism due to iodinated contrast agents.Several studies concerning CEUS for the characterization of both solid and cystic renal lesions have been published,but prospective multicenter studies are missing,the presented data being mainly descriptive.The aim of the this manuscript is to review the current literature for CEUS in renal masses,to summarize the available data and focus on possible concepts for studies in the future.展开更多
From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery（ONSS） without renal artery occlusion. We removed the lesions, and the cut edges of th...From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery（ONSS） without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.展开更多
AIM: To use magnetic resonance-guided high intensity focused ultrasound(MRg-HIFU), magnetic resonance imaging(MRI) and histopathology for noninvasively ablating, quantifying and characterizing ablated renal tissue. ME...AIM: To use magnetic resonance-guided high intensity focused ultrasound(MRg-HIFU), magnetic resonance imaging(MRI) and histopathology for noninvasively ablating, quantifying and characterizing ablated renal tissue. METHODS: Six anesthetized/mechanically-ventilated pigs underwent single/double renal sonication(n = 24) using a 3T-MRg-HIFU(1.1 MHz frequency and 3000J-4400 J energies). T2-weighted fast spin echo(T2-W), perfusion saturation recovery gradient echo and contrast enhanced(CE) T1-weighted(T1-W) sequences were used for treatment planning, temperature monitoring, lesion visualization, characterization and quantification, respectively. Histopathology was conducted in excised kidneys to quantify and characterize cellular and vascular changes. Paired Student's t-test was used and a P-value < 0.05 was considered statistically significant.RESULTS: Ablated renal parenchyma could not be differentiated from normal parenchyma on T2-W or nonCE T1-W sequences. Ablated renal lesions were visible as hypoenhanced regions on perfusion and CE T1-W MRI sequences, suggesting perfusion deficits and necrosis. Volumes of ablated parenchyma on CE T1-W images invivo(0.12-0.36 cm3 for single sonication 3000 J, 0.50-0.84 cm3, for double 3000 J, 0.75-0.78 cm3 for single 4400 J and 0.12-2.65 cm3 for double 4400J) and at postmortem(0.23-0.52 cm3, 0.25-0.82 cm3, 0.45-0.68 cm3 and 0.29-1.80 cm3, respectively) were comparable. The ablated volumes on 3000 J and 4400 J double sonication were significantly larger than single(P < 0.01), thus, the volume and depth of ablated tissue depends on the applied energy and number of sonication. Macroscopic and microscopic examinations confirmed the locations and presence of coagulation necrosis, vascular damage and interstitial hemorrhage, respectively.CONCLUSION: Contrast enhanced MRI provides assessment of MRg-HIFU renal ablation. Histopathology demonstrated coagulation necrosis, vascular damage and confirmed the volume of damage seen on MRI.展开更多
Acute kidney injuries (AKI) are a common problem encountered by internists in the inpatient and outpatient setting. Uncovering the etiology becomes important in tailoring treatment. Point-of-care ultrasound (POCUS), w...Acute kidney injuries (AKI) are a common problem encountered by internists in the inpatient and outpatient setting. Uncovering the etiology becomes important in tailoring treatment. Point-of-care ultrasound (POCUS), when used in conjunction with a patient’s history and physical exam, can quickly identify if hydronephrosis is present and shed light on the underlying etiology. In this article, we discuss how incorporating POCUS into the initial assessment of patients with an AKI can reduce the number of unnecessary and expensive formal renal ultrasounds and potentially expedite clinically appropriate treatment. The purpose of this review is to examine the benefits, reliability, and feasibility of POCUS to further evaluate and manage patients with AKI. An extensive review of the literature was performed and found POCUS to be a reliable and realistic method for internists to incorporate into their assessment of patients with AKI. In this article, we also provide instruction on how to perform a POCUS exam of the kidneys and how to identify hydronephrosis. Furthermore, we discuss the challenges we face and ideas for further practice including the emergence of hand-held ultrasounds.展开更多
目的探讨剪切波弹性成像(shear wave elastography,SWE)对高血压患者肾皮质弹性的临床价值。方法根据2020年国际高血压协会(International Society of Hypertension,ISH)高血压实践指南诊断标准,选取笔者医院心内科收治的44例单纯高血...目的探讨剪切波弹性成像(shear wave elastography,SWE)对高血压患者肾皮质弹性的临床价值。方法根据2020年国际高血压协会(International Society of Hypertension,ISH)高血压实践指南诊断标准,选取笔者医院心内科收治的44例单纯高血压患者,另选取同期健康对照组46例,收集一般资料及血液生化指标。并对所有研究对象进行二维超声检查和SWE弹性检测,获得常规超声指标及右肾皮质杨氏模量(Young’s modulus,YM)值,将上述参数进行两组间比较。将单纯高血压组右肾皮质YM值与一般资料、常规超声指标及肾功能等指标进行相关分析,并进行简单线性回归分析。结果单纯高血压组病程、收缩压、舒张压高于对照组,差异有统计学意义(P<0.05)。单纯高血压组右肾皮质YM值高于对照组,差异有统计学意义(P<0.05)。相关性分析结果显示右肾皮质YM值与高血压病程呈正相关(P<0.05);与年龄、血压、右肾体积、右肾皮质厚度、右肾动脉主干肾血流收缩期峰值流速(peaksystolicflowvelocity,PSV)、右肾动脉主干阻力指数(resistanceindex,RI)、血尿素氮、血肌酐、尿酸均无相关性(P>0.05)。进一步通过简单线性回归分析表明高血压病程为右肾皮质YM的独立影响因素。结论SWE可检测单纯性高血压患者肾脏皮质弹性变化。展开更多
文摘<strong>Introduction:</strong> In our practice, renal measurements in patients with normal renal function usually appear to be lower compared to standards reported in reference literature. The standards are probably different in our context. Given the importance of renal biometrics in nephrological practice, we felt it necessary to carry out this preliminary study in order to identify an order of reference measurements appropriate to our context. <strong>Methods:</strong> This was a cross-sectional study that took place from 18 August to 04 November 2018 at the Yalgado Ouedrarogo University Hospital Center. The first 100 subjects aged between 18 and 30 years who met the following inclusion criteria were selected: to be black african Burkinabe and to have normal renal function. The height, width and thickness of each kidney were measured using ultra-sound scanners. For statistical tests, a value of p < 0.05 was considered statistically significant. <strong>Results:</strong> The average age was 23.9 ± 6.1 years and the sex ratio was 2.2. Mean heights, widths and renal thicknesses were 94.5 ± 14.5, 38.7 ± 10.7 and 36.3 ± 10.3 mm, and 96.7 ± 16.7, 42.7 ± 16.7 and 36.8 ± 10.8 mm respectively for right and left kidneys. The distribution of the different renal dimensions in our sample followed a normal distribution. In the particular case of the right kidney, the probability that its height was between 79.2 and 109.7 mm was 0.95 and the probability that it was less than 79.2 mm or greater than 109.7 mm was 0.05. Renal height was significantly higher in subjects with height greater than 1.70 m (p ≤ 0.02). The left kidneys were on average significantly larger than the right kidneys (p = 0.0001). <strong>Conclusions:</strong> Our study is not extrapolable to the general population of Burkina Faso. It suggests, however, that the kidneys of the apparently healthy Burkinabe subject are smaller than what is reported in anatomy reference books. Our work, which is preliminary, should be deepened through a national survey. In the meantime, we should consider, in the nephrological assessment of the Burkinabe patient, the results of the renal biometrics we report.
文摘AIM:To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease(NAFLD)based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate.METHODS:A total of 170 subjects were enrolled in this study.All subjects were examined by ultrasound and 1H-magnetic resonance spectroscopy(1H-MRS)on the same day.The ultrasound hepatic/renal echointensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program.RESULTS:Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with 1HMRS liver fat content(ultrasound hepatic/renal ratio:r=0.952,P=0.000;hepatic echo-intensity attenuation r=0.850,P=0.000).The equation for predictingliver fat content by ultrasound(quantitative ultrasound model)is:liver fat content(%)=61.519×ultrasound hepatic/renal ratio+167.701×hepatic echo-intensity attenuation rate-26.736.Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase,aspartate aminotransferase,and triglyceride,but negatively correlated with high density lipoprotein cholesterol.Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15%in the quantitative ultrasound model.Furthermore,in the quantitative ultrasound model,fatty liver diagnostic sensitivity and specificity were 94.7%and 100.0%,respectively,showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate.If the 1H-MRS liver fat content had a value<15%,the sensitivity and specificity of the ultrasound quantitative model would be 81.4%and 100%,which still shows that using the model is better than the other methods.CONCLUSION:The quantitative ultrasound model is a simple,low-cost,and sensitive tool that can accurately assess hepatic fat content in clinical practice.It provides an easy and effective parameter for the early diagnosis of mild hepatic steatosis and evaluation of the efficacy of NAFLD treatment.
文摘Contrast enhanced ultrasound(CEUS) has gained clinical importance over the last years for the characterization of hepatic masses.Its role in extrahepatic indications has been investigated repeatedly but has been less comprehensively studied.Currently more than 50% of renal masses are incidentally diagnosed,mostly by B-mode ultrasound.The method of choice for characterization of renal lesions is contrast enhanced computed tomography(CECT).In the case of cystic lesions CECT refers to the Bosniak classification for cystic lesions to assess the risk of malignant behavior.The majority of masses are renal cell carcinoma,but the exact proportion is controversial.Disadvantages of CECT are a significant risk for patients with impaired renal function,allergic reactions and hyperthyroidism due to iodinated contrast agents.Several studies concerning CEUS for the characterization of both solid and cystic renal lesions have been published,but prospective multicenter studies are missing,the presented data being mainly descriptive.The aim of the this manuscript is to review the current literature for CEUS in renal masses,to summarize the available data and focus on possible concepts for studies in the future.
文摘From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery（ONSS） without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.
文摘AIM: To use magnetic resonance-guided high intensity focused ultrasound(MRg-HIFU), magnetic resonance imaging(MRI) and histopathology for noninvasively ablating, quantifying and characterizing ablated renal tissue. METHODS: Six anesthetized/mechanically-ventilated pigs underwent single/double renal sonication(n = 24) using a 3T-MRg-HIFU(1.1 MHz frequency and 3000J-4400 J energies). T2-weighted fast spin echo(T2-W), perfusion saturation recovery gradient echo and contrast enhanced(CE) T1-weighted(T1-W) sequences were used for treatment planning, temperature monitoring, lesion visualization, characterization and quantification, respectively. Histopathology was conducted in excised kidneys to quantify and characterize cellular and vascular changes. Paired Student's t-test was used and a P-value < 0.05 was considered statistically significant.RESULTS: Ablated renal parenchyma could not be differentiated from normal parenchyma on T2-W or nonCE T1-W sequences. Ablated renal lesions were visible as hypoenhanced regions on perfusion and CE T1-W MRI sequences, suggesting perfusion deficits and necrosis. Volumes of ablated parenchyma on CE T1-W images invivo(0.12-0.36 cm3 for single sonication 3000 J, 0.50-0.84 cm3, for double 3000 J, 0.75-0.78 cm3 for single 4400 J and 0.12-2.65 cm3 for double 4400J) and at postmortem(0.23-0.52 cm3, 0.25-0.82 cm3, 0.45-0.68 cm3 and 0.29-1.80 cm3, respectively) were comparable. The ablated volumes on 3000 J and 4400 J double sonication were significantly larger than single(P < 0.01), thus, the volume and depth of ablated tissue depends on the applied energy and number of sonication. Macroscopic and microscopic examinations confirmed the locations and presence of coagulation necrosis, vascular damage and interstitial hemorrhage, respectively.CONCLUSION: Contrast enhanced MRI provides assessment of MRg-HIFU renal ablation. Histopathology demonstrated coagulation necrosis, vascular damage and confirmed the volume of damage seen on MRI.
文摘Acute kidney injuries (AKI) are a common problem encountered by internists in the inpatient and outpatient setting. Uncovering the etiology becomes important in tailoring treatment. Point-of-care ultrasound (POCUS), when used in conjunction with a patient’s history and physical exam, can quickly identify if hydronephrosis is present and shed light on the underlying etiology. In this article, we discuss how incorporating POCUS into the initial assessment of patients with an AKI can reduce the number of unnecessary and expensive formal renal ultrasounds and potentially expedite clinically appropriate treatment. The purpose of this review is to examine the benefits, reliability, and feasibility of POCUS to further evaluate and manage patients with AKI. An extensive review of the literature was performed and found POCUS to be a reliable and realistic method for internists to incorporate into their assessment of patients with AKI. In this article, we also provide instruction on how to perform a POCUS exam of the kidneys and how to identify hydronephrosis. Furthermore, we discuss the challenges we face and ideas for further practice including the emergence of hand-held ultrasounds.
文摘目的探讨剪切波弹性成像(shear wave elastography,SWE)对高血压患者肾皮质弹性的临床价值。方法根据2020年国际高血压协会(International Society of Hypertension,ISH)高血压实践指南诊断标准,选取笔者医院心内科收治的44例单纯高血压患者,另选取同期健康对照组46例,收集一般资料及血液生化指标。并对所有研究对象进行二维超声检查和SWE弹性检测,获得常规超声指标及右肾皮质杨氏模量(Young’s modulus,YM)值,将上述参数进行两组间比较。将单纯高血压组右肾皮质YM值与一般资料、常规超声指标及肾功能等指标进行相关分析,并进行简单线性回归分析。结果单纯高血压组病程、收缩压、舒张压高于对照组,差异有统计学意义(P<0.05)。单纯高血压组右肾皮质YM值高于对照组,差异有统计学意义(P<0.05)。相关性分析结果显示右肾皮质YM值与高血压病程呈正相关(P<0.05);与年龄、血压、右肾体积、右肾皮质厚度、右肾动脉主干肾血流收缩期峰值流速(peaksystolicflowvelocity,PSV)、右肾动脉主干阻力指数(resistanceindex,RI)、血尿素氮、血肌酐、尿酸均无相关性(P>0.05)。进一步通过简单线性回归分析表明高血压病程为右肾皮质YM的独立影响因素。结论SWE可检测单纯性高血压患者肾脏皮质弹性变化。
