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Renal Elasticity Quantification by Acoustic Radiation Force Impulse Applied to the Evaluation of Kidney Diseases
  1. Marco Zaffanello, MD*,
  2. Giorgio Piacentini, MD*,
  3. Costanza Bruno, MD,
  4. Milena Brugnara, MD*,
  5. Vassilios Fanos, MD
  1. From the *Pediatric Division, Department of Life and Reproduction Sciences, and †Department of Radiology, University of Verona, Verona; and ‡Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, University of Cagliari, Cagliari, Italy.
  1. Received July 3, 2014, and in revised form January 2, 2015.
  2. Accepted for publication January 22, 2015.
  3. Reprints: Marco Zaffanello, MD, Pediatric Division Department of Life and Reproduction Sciences, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. E-mail: marco.zaffanello{at}
  4. All of the authors contributed to the collection, analysis, and review of the data published in the literature. M.Z. wrote the paper. All the authors critically reviewed the manuscript before submission.
  5. No funding was received for this study.
  6. None of the authors declared a conflict of interest.

A Review


For centuries, clinicians have used palpation to evaluate abdominal organs. After exploring almost all the different methods of interaction between x-rays, ultrasound, and magnetic fields on tissues, recent interest has focused on the evaluation of their mechanical properties.

Acoustic radiation force impulse (ARFI) is a recent, established ultrasound-based diagnostic technique that allows physicians to obtain a measure of the elastic properties of an organ. Shear wave velocity, obtained by the ARFI technique, depends on the elasticity of tissues.

To date, there are studies on the ARFI technique applied to normal kidneys, chronic kidney diseases, and kidney transplants. Mechanical properties of the kidney, such as stiffness and deformity, depend on various conditions that alter its histology, in particular the amount of fibrosis in the renal parenchyma; urinary pressure and renal blood perfusion may be other important contributing factors. Unfortunately, the ARFI technique applied to native renal pathologies is still limited, and not all studies are comparable because they used different methods. Therefore, the results reported in recent literature encourage further improvement of this method and the drawing up of standardized guidelines of investigation.

Key Words
  • acoustic radiation force impulse
  • chronic kidney disease
  • estimated glomerular filtration rate
  • renal allograft
  • renal fibrosis
  • renal perfusion
  • urinary pressure

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