Doppler ultrasound imaging and shear wave elastography for evaluation of interstitial fibrosis/tubular atrophy in IgA nephropathy

The purpose of this study was to explore the value of Doppler ultrasound imaging and shear wave elastography (SWE) in evaluating renal interstitial fibrosis/tubular atrophy (IFTA).

During April 2019 and November 2023, biopsy-proven IgA nephropathy (IgAN) patients were enrolled in our study. Conventional ultrasound, Doppler ultrasound imaging and SWE measurements were performed, and related parameters were collected. According to the Oxford classification of IgAN, interstitial fibrosis/tubular atrophy (T) lesions were grouped into T0, T1 and T2 group. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic accuracy of SWE in identifying IFTA.

A total of 100 IgAN patients were enrolled in the final cohort. 67 patients were in the T0 group, and 33 patients were in the T1/T2 group. The average SWE values were 42.17 ± 9.11 kPa in the T0 group and 36.83 ± 10.32 kPa in the T1/T2 group (p = 0.01). Multivariate logistic regression revealed that the SWE value and end diastolic velocity (EDV) of the interlobar artery were found to be independent risk factors for IFTA. For the diagnosis of IFTA, the area under the ROC curve (AUC) of SWE alone was 0.652, whereas the AUC of SWE in combination with the EDV was 0.807 (p = 0.008).

The combination of Doppler ultrasound imaging and SWE measurements could improve the diagnostic performance of quantitative assessment of IFTA in IgAN patients.