In Vivo Assessment of Hypertensive Nephrosclerosis Using Ultrasound Localization Microscopy

TL;DR

This study demonstrates that ultrasound localization microscopy (ULM) can detect microvascular changes in hypertensive nephrosclerosis earlier and more reliably than traditional ultrasound methods, potentially enabling earlier diagnosis of CKD.

Contribution

The paper introduces ULM as a more sensitive imaging technique for early detection of hypertensive nephrosclerosis compared to conventional ultrasound and clinical tests.

Findings

ULM shows significantly higher blood flow speed in hypertensive rats.

Conventional ultrasound indicators did not differ between hypertensive and healthy rats.

TTP from contrast-enhanced ultrasound was significantly different, but less sensitive than ULM.

Abstract

Purpose: As a typical chronic kidney disease (CKD), hypertensive nephrosclerosis (HN) is a common syndrome of hypertension, characterized by chronic kidney microvascular damage. Early diagnosis of microvascular damage using conventional ultrasound imaging encounters challenges in sensitivity and specificity owing to the inherent diffraction limit. Ultrasound localization microscopy (ULM) has been developed to obtain microvasculature and microvascular hemodynamics within the kidney, and would be a promising tool for early diagnosis of CKD. Methods: In this study, the advantage of ULM over conventional clinical inspection (serum and urine tests) and ultrasound imaging (Doppler and contrast-enhanced ultrasound imaging) for early diagnosis of HN was investigated. Examinations were carried out on 6 spontaneously hypertensive rats (SHR) and 5 normal Wistar-Kyoto (WKY) rats at the age of 10 weeks. Results: The experimental results showed that the indicators derived from conventional clinical inspection and ultrasound imaging (PSV, EDV, RI, RT, IMAX, mTT and AUC) did not show significant difference between hypertensive and healthy rats (p > 0.05), while the TTP derived from CEUS (p < 0.05) and the mean blood flow speed in artery of SHR derived from ULM is significantly higher than that of WKY rats (p < 0.01). Conclusion: The quantitative results showed that ULM has higher sensitivity than conventional clinical inspection and ultrasound imaging. ULM may promise a reliable solution for early diagnosis of HN.