Ultrassonografia convencional e elastografia ARFI (Acoustic Radiation Force Impulse) na avaliação renal de gatos adultos hígidos
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Data
2016-07-13
Autores
Garcia, Paulo Henrique de Souza [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O exame ultrassonográfico convencional tem baixa especificidade para detecção de alterações difusas, no entanto, o aumento da ecogenicidade renal é um dos achados mais comuns em cães e gatos com nefropatia. O objetivo deste estudo foi descrever a técnica de elastografia por irradiação da força de impulso acústico (ARFI) na avaliação dos rins de gatos adultos hígidos, e determinar os valores de referência. Foram incluídos neste trabalho dez gatos de pelo curto, adultos e saudáveis. Após sedação, foi realizada uma ampla tricotomia abdominal, para a realização do exame ultrassonográfico. O exame convencional, em Modo B foi realizado com um transdutor linear de 9,0 MHz usando equipamento de ultrassom ACUSON S2000 / SIEMENS (Siemens, Munique, Alemanha). A ecogenicidade, ecotextura, o tamanho e contornos renais foram avaliados. Com o mesmo transdutor, a elastografia foi realizada utilizando software para comparação das análises qualitativa e quantitativa do método. A elastografia qualitativa detectou a presença de deformidades e as velocidades de cisalhamento em diferentes locais (cranial, média e caudal) das regiões cortical e medular em ambos os rins. Os achados ultrassonográficos foram considerados normais em todos os gatos, sem alterações em arquitetura ou ecogenicidade renal. A elastografia qualitativa demonstrou que o córtex renal era deformável e apresentou áreas cinza escuro homogêneas; pelve renal tinha pouca rigidez (branca); e da medula mostrou um padrão de mosaico. Os resultados de velocidade de onda de cisalhamento foram diferentes em regiões cranial, média e caudal do córtex e medula: 2,46 m/s ± 0,45 m/s; 2,46m/s ± 0,48 m/s e 2, 37 m/s ± 0, 42 m/s (P = 0,795) no córtex e 1,61 m/s ± 0,69 m/s, 1,75 m/s ± 0,66 m/s e 2,00 m/s ± 0,55 m/s (P = 0,156) na medula, respectivamente. A ARFI quantitativa e qualitativa do rim em gatos adultos foi realizada facilmente e este estudo forneceu valores de referência para a caracterização da normalidade do parênquima renal em gatos hígidos.
Conventional ultrasonography has low specificity to detect diffuse changes, however, increased renal echogenicity is one of the most common findings in dogs and cats with nephropathy. The objective of this study was to describe elastography by acoustic radiation force impulse (ARFI) in the assessment of adult cats' kidneys and determine reference values. Ten healthy adults short hair cats were included. After sedation, abdominal hair was clipped in order to perform ultrasound exams. The conventional examination (B-mode) was performed with a 9.0 MHz linear array transducer ultrasound equipment using ACUSON S2000/Siemens (Siemens, Munich, Germany). Echogenicity, echotexture, size and contours of each kidney were evaluated. With the same transducer, elastography was performed using a software that compares qualitative and quantitative analysis. Qualitative elastography detected deformities and shear wave velocity rates in different portions (cortical and medulla' cranial, media and caudal regions). The sonographic findings were normal in all cats, with no changes in renal architecture or echogenicity. Qualitative elastography showed that renal cortex was softer with dark gray homogeneous areas; renal pelvis presented lower stiffness (white); and medulla showed a mosaic pattern. Shear wave velocities were obtained in cranial, medial, and caudal regions of the cortex and medulla: 2.46 m/s ± 0.45m/s; 2,46m/s ± 0.48 m/ s 2,37 m/s ± 0, 42 m/s (P = 0.795) in the cortex and 1.61 m/s ± 0.69 m/s 1.75 m/s ± 0.66 m/s and 2.00m/s ± 0.55m/s (P = 0.156) in medulla, respectively. Quantitative and qualitative ARFI kidney in adult cats was easily accomplished and this study was able to provide values for the characterization of the normal renal parenchyma in healthy cats.
Conventional ultrasonography has low specificity to detect diffuse changes, however, increased renal echogenicity is one of the most common findings in dogs and cats with nephropathy. The objective of this study was to describe elastography by acoustic radiation force impulse (ARFI) in the assessment of adult cats' kidneys and determine reference values. Ten healthy adults short hair cats were included. After sedation, abdominal hair was clipped in order to perform ultrasound exams. The conventional examination (B-mode) was performed with a 9.0 MHz linear array transducer ultrasound equipment using ACUSON S2000/Siemens (Siemens, Munich, Germany). Echogenicity, echotexture, size and contours of each kidney were evaluated. With the same transducer, elastography was performed using a software that compares qualitative and quantitative analysis. Qualitative elastography detected deformities and shear wave velocity rates in different portions (cortical and medulla' cranial, media and caudal regions). The sonographic findings were normal in all cats, with no changes in renal architecture or echogenicity. Qualitative elastography showed that renal cortex was softer with dark gray homogeneous areas; renal pelvis presented lower stiffness (white); and medulla showed a mosaic pattern. Shear wave velocities were obtained in cranial, medial, and caudal regions of the cortex and medulla: 2.46 m/s ± 0.45m/s; 2,46m/s ± 0.48 m/ s 2,37 m/s ± 0, 42 m/s (P = 0.795) in the cortex and 1.61 m/s ± 0.69 m/s 1.75 m/s ± 0.66 m/s and 2.00m/s ± 0.55m/s (P = 0.156) in medulla, respectively. Quantitative and qualitative ARFI kidney in adult cats was easily accomplished and this study was able to provide values for the characterization of the normal renal parenchyma in healthy cats.
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Palavras-chave
Ultrassonografia, Gatos, Rins, Elastografia, Ultrasound, Cat, Kidney, Elastography