Evaluación de la rigidez hepática y renal mediante elastografía cuantitativa con técnica ARFI en modelos experimentales de rata

Laburpena

Chronic liver and kidney diseases are a potential cause of morbidity and mortality in developed countries. Its pathophysiology is based, among other factors, on the development of a progressive and often irreversible parenchymal fibrosis, which leads to the malfunction of these organs. Currently, biopsy is still the "gold standard" method to evaluate these affections, despite its sampling limitations and possible complications, some of them potentially fatal. Recently, non-invasive diagnostic methods have been emerging to quantify the degree of hepatic and renal damage by measuring the changes in parenchymal elasticity. Elastographic methods based on ultrasound, including the ARFI (Acoustic Radiation Force Impulse) technique, have shown promising results as a non-invasive diagnostic method for the diagnosis and grading of chronic liver and kidney disease. However, the techniques have several limitations. In order to clarify these points, we have evaluated the hepatic and renal parenchymal elasticity using the ARFI technique in two experimental rat animal models (with induction of different degrees of liver disease and nephropathy). Moreover, we have carried out a correlation study with the analytical and histological values. The studies were carried out both in vivo and ex vivo to: 1) determine possible measurement artifact factors, 2) establish possible correlations between the different types of measurements and 3) try to optimize the acquisition of values using the ARFI technique. Both in hepatic and renal parenchyma, the results showed an increase in the ARFI values in the in vivo studies compared to the ex vivo ones, which suggests that several factors can alter the measurements. In addition, we detected a high correlation values between the measurements acquired with ARFI and the degree of fibrosis, more evident in liver parenchyma, and, especially, in ex vivo scans. These results could indicate a possible overestimation of the measures in the in vivo method. Proper planning and optimization in the acquisition of ARFI measurements could limit these f artifact sources, to obtain a more reliable, accurate and reproducible results. On the other hand, we have observed ARFI measurements alterations in animals with low histological degrees of hepatopathy and nephropathy and normal analytical parameters. These findings highlight the potential ability of the ARFI sonoelastographic technique to detect pathology early.