Renal elasticity and perfusion changes on ultrasonography in an early-stage diabetic rat model

Yan Li; Zi-Shuo Liu; Ran Wei; Zhi-Wen Liu; Li-Xin Guo; Jun-Hong Ren

doi:10.21037/qims-23-409

Renal elasticity and perfusion changes on ultrasonography in an early-stage diabetic rat model

Quant Imaging Med Surg. 2023 Dec 1;13(12):7667-7679. doi: 10.21037/qims-23-409. Epub 2023 Oct 13.

Authors

Yan Li^{1

2}, Zi-Shuo Liu², Ran Wei^{3

4}, Zhi-Wen Liu², Li-Xin Guo^{3

4}, Jun-Hong Ren^{1

2}

Affiliations

¹ Department of Sonography, Graduate School of Peking Union Medical College, Beijing, China.
² Department of Sonography, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
³ Department of Endocrinology, Peking University Fifth School of Clinical Medicine, Beijing, China.
⁴ Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Background: Renal hemodynamic changes in early diabetes occur before the onset of significant structural abnormalities or clinical manifestations, and timely detection of these changes has clinical significance. This study aimed to evaluate renal elasticity and perfusion changes in an early-stage diabetic rat model by shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS), and to explore the potential correlations between renal elasticity and perfusion parameters.

Methods: A total of 18 male Sprague-Dawley rats were randomly divided into three groups: a control group (group 1, n=6), a diabetic group (group 2, n=6), and a diabetic group receiving drug therapy (group 3, n=6). An intraperitoneal injection of streptozotocin (STZ) for 2 days combined with a high-fat diet (HFD) was used as the early-stage diabetic rat model. The diabetic rats in group 3 were treated with canagliflozin and losartan for 6 weeks, whereas the rats in groups 1 and 2 were given equal amounts of purified water. Renal stiffness on SWE and perfusion parameters on CEUS were measured and compared among the three groups, then the rats were sacrificed, and serum, urine, and renal histopathology were evaluated to confirm the development of early diabetes.

Results: The early-stage diabetic rats without significant pathological changes exhibited bigger kidneys and higher blood glucose (all P<0.05). Among the CEUS parameters, peak enhancement (PE), wash-in area under the curve (WiAUC), wash-in perfusion index (WiPI), wash-out AUC (WoAUC), wash-in and wash-out AUC (WiWoAUC), rise time (RT), and time to peak (TTP) of diabetic rats in group 2 were significantly increased (all P<0.05), and the hyperperfusion ameliorated significantly after drug treatment. The renal elasticity measured by SWE varied in accordance with certain perfusion parameters, and was strongly positively correlated with WiAUC (r=0.701, P<0.001), WoAUC (r=0.647, P<0.001), and WiWoAUC (r=0.655, P<0.001), and moderately positively correlated with PE (r=0.539, P=0.001), WiPI (r=0.555, P<0.001), RT (r=0.425, P=0.010), and TTP (r=0.439, P=0.007).

Conclusions: Renal elasticity and perfusion changes in the early stage of diabetes, and renal elasticity was positively associated with delayed and increased perfusion.

Keywords: Contrast-enhanced ultrasound (CEUS); diabetes; renal perfusion; shear wave elastography (SWE).