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Urinary Tract Tuberculosis and Its Ultrasound Findings
S210
Ultrasound in Medicine and Biology
(p,0.05). Mean PI values were: 1.27 for ND group (SD 5 0.33 95%CI), 1.04 for HT group (SD 5 0.24), t-test was also highly significant with values under 0.05. Cut-off values for RI in incipient DN were above 0.72. PI values were higher with age in diabetic patients. Pi and RI were highly significant in case of patients with more than 5 years from the onset of diabetes. Conclusions: RI can be considered a suggestive parameter for the presence of DN. PI alongside RI correlated with the duration of diabetes, age and incipient DN. The Doppler US examination is difficult but objective measurements are still to be developed. OPT16-003 The Relationship between Kidney Shear Wave Speed Measured Using the Elastpq Technique and Different Biomarkers of Chronic Kidney Disease Flaviu Bob,1 Iulia Grosu,1 Ioan Sporea,2 Romulus Timar,3 Alina Popescu,2 Roxana Sirli,2 Georgeta Bujor,4 Ligia Petrica,1 Adalbert Schiller1 1 Department of Nephrology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, Romania, 2Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, 3Department of Nutrition and Metabolic Diseases, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, 4 Department of Biochemistry, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara Objectives: The present study aims to find a relationship between kidney shear wave speed (KSWS) measured using Elastography Point Quantification (ElastPQ) and different biomarkers of chronic kidney disease (CKD): a tubular injury marker- kidney injury molecule-1 (KIM-1), a marker of interstitial inflammation- urinary monocyte chemoattractive protein 1 (MCP1), markers of fibrogenesis- connective tissue growth factor (CTGF), and soluble Klotho, that inhibits fibrogenesis, as a pleiotropic effect. Methods: Our study included 38 patients (mean age 56.5+/-16.12 years; 19 female, 19 male) with diabetic kidney disease. In all patients KSWS was measured using ElastPQ (Philips Affinity) and median values of 5 valid KSWS measurements were calculated and expressed in meters/ second (m/s). In all patients we assessed renal function- glomerular filtration rate (eGFR), and using an ELISA method, serum levels of: KIM-1, CTGF, klotho, and urinary levels of MCP1. Results: We obtained a mean KSWS of 0.98+/-0.40 m/s (right kidney) and 0.90+/-0.37 m/s (left kidney). KSWS was significantly lower in male vs. female subjects (0.77 vs. 1.02 m/s, p50.05), and in patients with eGFR , 60ml/min (0.8 vs. 1.1 m/s, p50.05). KSWS showed also a decrease with age (r5-0.53, p50.0009). We found a statistically significant correlation of KSWS with urinary MCP1 (r50.34, p50.05), and with the level of sKlotho (r50.56, p50.03), but no correlation with CTGF and KIM-1. Conclusions: Our study shows that KSWS is decreased in advanced stages of CKD, and this decreased levels are associated to reduced interstitial infiltration (urinary MCP1) and probably to increased interstitial fibrosis (low soluble Klotho). OPT16-004 Pitfalls in Kidney Ultrasonography: Rare Diseases Paula Maria Chiril a,1 Cristian Nicolae Chirila,1 Mirela Liana Gliga,2 Daniela Maria Podeanu,3 Adriana Gomot^ arceanu,4 Sanda Voicu,5 Claudia Cozma,6 Imola Torok7 1 Department of General Medicine, University of Medicine and Pharmacy Targu Mures, Romania, 2Department of Nephrology, University of Medicine and Pharmacy Targu Mures, Diaverum Dialysis Center, 3Department of Radiology, Emergency County Hospital Targu Mures, 4Department of Internal Medicine, Topmed Medical Center
Volume 43, Number S1, 2017 Targu Mures, 5Department of Pediatrics, University of Medicine and Pharmacy Targu Mures, 6Department of General Practice, Topmed Medical Center Targu Mures, 7Department of Internal Medicine, University of Medicine and Pharmacy Targu Mures Objectives: Ultrasonography (US) is well known to improve the quality of the clinical diagnosis due to its rapidity, repeatability and non-invasivity. While the physician is accustomed to frequent diseases, rare conditions may not be recognized. Our aim is to describe US images in rare kidney diseases and discuss some diagnostic implications in the detection of these pathologies. Methods: We analyzed the morphological US aspects in patients from the Nephrology Department of the Mures¸ County Clinical Hospital during a period of ten years. We performed a routine abdominal US for all cases. The examination was made with various US devices. The final positive diagnosis was made by clinical or other imaging modalities. Results: We found 19 patients (0.095% of the total investigations) with specific clinical presentations and suggestive US imaging for rare renal diseases: 6 cases with medullary sponge kidney, 2 with persistence of fetal lobulation, 2 cases with hydatid cyst, 2 HIV associated nephropathies, one post-biopsy arterio-venous fistula, 2 cases with tuberous sclerosis complex, one case with superior renal artery branch stenosis, one rare mixed urothelial and sarcomatous tumor and two rare images in renal tuberculosis. For each case we described the US appearance and discussed the pitfalls that may lead to misdiagnosis. Conclusions: US is an important investigation in urology and nephrology. Being aware of rare diseases or rare US images is important in order to establish the final positive diagnosis and avoid unnecessary invasive and expensive procedures. OPT16-005 Urinary Tract Tuberculosis and Its Ultrasound Findings Maria Goretti Ametembun Department of Internal Medicine, Cicendo Eye Hospital, Bandung, Indonesia Objectives: To describe the urinary tract tuberculosis and its ultrasound findings. Methods: This cross sectional study was conducted at Emma Poeradiredja Hospital Bandung, from August 21, 2008 to January 28, 2012. All peritoneal dry type tuberculosis patients with history of recurrent flank pain, frequent urination, dysuria, urine positive PCR Mycobacterium tuberculosis, positive tuberculin test, negative urine culture of other microorganism, lymphocytosis, high erythrocyte sedimentation rate were examined with ALOKA-Prosound-SSD3500 by one certified ultrasound internal medicine doctor. Results: N5 34, 5-77 years, mean 47.4. 23(68%) female and 11(32%) male. The kidneys: size were 7.9-11.8 cm (mean 10.3) length and 3.3-5.9 cm (mean 4.06) width, irregular parenchymal thickness between 1-2.8 cm (mean 1.4). In the affected area: irregular renal surface, poor differentiation of capsule, cortex, and pyramids as well as ill defined of sinus echo pattern, hypoechodensity and hypovascularisation in addition of some irregular oval/round lesions (patchy echogenic non- shadowing with an irregular rim of lower echodensity) with diameter of 0.7-2.1 cm (mean 1.4). There were 3 (10%) pelvicaliectasis, 7 (23%), complex cysts and 3 (10%) nephrolithiasis, The urinary bladder: irregularly focal or diffuse bladder mucosal wall thickening (5.0-11.4 mm) in addition of some irregular oval/round lesions (patchy echogenic non-shadowing with an irregular rim of lower echodensity) within the thickening wall of the bladder. 2 (7%) were pyuria, 2 (7%) urinary retention, 1 (3%) vesicolithiasis. Ureteric jets were normal. Conclusions: Urinary tract tuberculosis and its ultrasound findings showed various chronic manifestations.
Ultrasound in Medicine and Biology
(p,0.05). Mean PI values were: 1.27 for ND group (SD 5 0.33 95%CI), 1.04 for HT group (SD 5 0.24), t-test was also highly significant with values under 0.05. Cut-off values for RI in incipient DN were above 0.72. PI values were higher with age in diabetic patients. Pi and RI were highly significant in case of patients with more than 5 years from the onset of diabetes. Conclusions: RI can be considered a suggestive parameter for the presence of DN. PI alongside RI correlated with the duration of diabetes, age and incipient DN. The Doppler US examination is difficult but objective measurements are still to be developed. OPT16-003 The Relationship between Kidney Shear Wave Speed Measured Using the Elastpq Technique and Different Biomarkers of Chronic Kidney Disease Flaviu Bob,1 Iulia Grosu,1 Ioan Sporea,2 Romulus Timar,3 Alina Popescu,2 Roxana Sirli,2 Georgeta Bujor,4 Ligia Petrica,1 Adalbert Schiller1 1 Department of Nephrology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, Romania, 2Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, 3Department of Nutrition and Metabolic Diseases, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, 4 Department of Biochemistry, University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara Objectives: The present study aims to find a relationship between kidney shear wave speed (KSWS) measured using Elastography Point Quantification (ElastPQ) and different biomarkers of chronic kidney disease (CKD): a tubular injury marker- kidney injury molecule-1 (KIM-1), a marker of interstitial inflammation- urinary monocyte chemoattractive protein 1 (MCP1), markers of fibrogenesis- connective tissue growth factor (CTGF), and soluble Klotho, that inhibits fibrogenesis, as a pleiotropic effect. Methods: Our study included 38 patients (mean age 56.5+/-16.12 years; 19 female, 19 male) with diabetic kidney disease. In all patients KSWS was measured using ElastPQ (Philips Affinity) and median values of 5 valid KSWS measurements were calculated and expressed in meters/ second (m/s). In all patients we assessed renal function- glomerular filtration rate (eGFR), and using an ELISA method, serum levels of: KIM-1, CTGF, klotho, and urinary levels of MCP1. Results: We obtained a mean KSWS of 0.98+/-0.40 m/s (right kidney) and 0.90+/-0.37 m/s (left kidney). KSWS was significantly lower in male vs. female subjects (0.77 vs. 1.02 m/s, p50.05), and in patients with eGFR , 60ml/min (0.8 vs. 1.1 m/s, p50.05). KSWS showed also a decrease with age (r5-0.53, p50.0009). We found a statistically significant correlation of KSWS with urinary MCP1 (r50.34, p50.05), and with the level of sKlotho (r50.56, p50.03), but no correlation with CTGF and KIM-1. Conclusions: Our study shows that KSWS is decreased in advanced stages of CKD, and this decreased levels are associated to reduced interstitial infiltration (urinary MCP1) and probably to increased interstitial fibrosis (low soluble Klotho). OPT16-004 Pitfalls in Kidney Ultrasonography: Rare Diseases Paula Maria Chiril a,1 Cristian Nicolae Chirila,1 Mirela Liana Gliga,2 Daniela Maria Podeanu,3 Adriana Gomot^ arceanu,4 Sanda Voicu,5 Claudia Cozma,6 Imola Torok7 1 Department of General Medicine, University of Medicine and Pharmacy Targu Mures, Romania, 2Department of Nephrology, University of Medicine and Pharmacy Targu Mures, Diaverum Dialysis Center, 3Department of Radiology, Emergency County Hospital Targu Mures, 4Department of Internal Medicine, Topmed Medical Center
Volume 43, Number S1, 2017 Targu Mures, 5Department of Pediatrics, University of Medicine and Pharmacy Targu Mures, 6Department of General Practice, Topmed Medical Center Targu Mures, 7Department of Internal Medicine, University of Medicine and Pharmacy Targu Mures Objectives: Ultrasonography (US) is well known to improve the quality of the clinical diagnosis due to its rapidity, repeatability and non-invasivity. While the physician is accustomed to frequent diseases, rare conditions may not be recognized. Our aim is to describe US images in rare kidney diseases and discuss some diagnostic implications in the detection of these pathologies. Methods: We analyzed the morphological US aspects in patients from the Nephrology Department of the Mures¸ County Clinical Hospital during a period of ten years. We performed a routine abdominal US for all cases. The examination was made with various US devices. The final positive diagnosis was made by clinical or other imaging modalities. Results: We found 19 patients (0.095% of the total investigations) with specific clinical presentations and suggestive US imaging for rare renal diseases: 6 cases with medullary sponge kidney, 2 with persistence of fetal lobulation, 2 cases with hydatid cyst, 2 HIV associated nephropathies, one post-biopsy arterio-venous fistula, 2 cases with tuberous sclerosis complex, one case with superior renal artery branch stenosis, one rare mixed urothelial and sarcomatous tumor and two rare images in renal tuberculosis. For each case we described the US appearance and discussed the pitfalls that may lead to misdiagnosis. Conclusions: US is an important investigation in urology and nephrology. Being aware of rare diseases or rare US images is important in order to establish the final positive diagnosis and avoid unnecessary invasive and expensive procedures. OPT16-005 Urinary Tract Tuberculosis and Its Ultrasound Findings Maria Goretti Ametembun Department of Internal Medicine, Cicendo Eye Hospital, Bandung, Indonesia Objectives: To describe the urinary tract tuberculosis and its ultrasound findings. Methods: This cross sectional study was conducted at Emma Poeradiredja Hospital Bandung, from August 21, 2008 to January 28, 2012. All peritoneal dry type tuberculosis patients with history of recurrent flank pain, frequent urination, dysuria, urine positive PCR Mycobacterium tuberculosis, positive tuberculin test, negative urine culture of other microorganism, lymphocytosis, high erythrocyte sedimentation rate were examined with ALOKA-Prosound-SSD3500 by one certified ultrasound internal medicine doctor. Results: N5 34, 5-77 years, mean 47.4. 23(68%) female and 11(32%) male. The kidneys: size were 7.9-11.8 cm (mean 10.3) length and 3.3-5.9 cm (mean 4.06) width, irregular parenchymal thickness between 1-2.8 cm (mean 1.4). In the affected area: irregular renal surface, poor differentiation of capsule, cortex, and pyramids as well as ill defined of sinus echo pattern, hypoechodensity and hypovascularisation in addition of some irregular oval/round lesions (patchy echogenic non- shadowing with an irregular rim of lower echodensity) with diameter of 0.7-2.1 cm (mean 1.4). There were 3 (10%) pelvicaliectasis, 7 (23%), complex cysts and 3 (10%) nephrolithiasis, The urinary bladder: irregularly focal or diffuse bladder mucosal wall thickening (5.0-11.4 mm) in addition of some irregular oval/round lesions (patchy echogenic non-shadowing with an irregular rim of lower echodensity) within the thickening wall of the bladder. 2 (7%) were pyuria, 2 (7%) urinary retention, 1 (3%) vesicolithiasis. Ureteric jets were normal. Conclusions: Urinary tract tuberculosis and its ultrasound findings showed various chronic manifestations.