The efficacy of sonoelastography method for the diagnosis of fibrosis in renal transplant patients

Allograft biopsy is the most important method in the diagnosis of ethiological factors of dysfunction of renal allografts. Sonoelastography is a new ultrasound method which is used to distinguish the soft or hard nature of the lesions numerically. The aim of this study is to investigate the efficacy of sonoelastography method for the diagnosis of fibrosis in renal transplant patients. This study was performed prospectively in the Department of Radiology of Baskent University. Patients over the age of 18 with renal allografts, to whom clinical biopsies were recommended were included in this study. Sonoelastography measurements for the renal transplant patients, who were admitted to the clinic for biopsy, were performed just before the biopsy procedure. Sonoelastography measurements were not used for final decision of biopsy. In all cases Siemens S 3000 Ultrasound was used for imaging. Comparison of sonoelastographic values with biopsy results was made by SPSS 20 Statistics program. The average age of the patients was 38.84 ± 14. Of all patient, 51 (78.5 %) had live donors and 14 (21.5%) had cadaveric donors. Pathology has approved chronic active humoral rejection in 11 patients (16.9%), acute T-cell mediated rejection in 37 patients (56,9%), acute humoral rejection in 2 patients (3.1%) , acute tubulointerstitial nephritis in 1 patient (1.5%), inhibitor toxicity of chronic calcineurin in 8 patients (12.3%) and thrombotic microangiopathy in 1 patient (1.5%) Our study demonstrates that ARFI average values increase as the interstitial fibrosis ratio increases in patients with grade II and III interstitial fibrosis. In addition, we have concluded that ARFI measurements taken before biopsy, can help for the decision of biopsy region. It can be stated that ARFI method is benefical in the diagnosis of interstitial fibrosis in renal transplant patients.