BACKGROUND: A correlation between acquired renal cysts in the dialysed kidney and renal cancer has long been debated, but no changes in the physical properties of kidneys at the microscopic level have been reported. The purpose of the present study was to classify the physical properties of the kidneys of patients undergoing haemodialysis at several stages of pathology by use of the scanning acoustic microscope. METHODS: Sixteen surgically excised kidneys of dialysis patients were investigated. Tissues were fixed in 10% formalin, frozen in acetone, and cut 10 microns thick on a cryostat. We used a scanning acoustic microscope operated in the frequency range of 100-200 MHz. Attenuation constant and sound speed were measured on a two-dimensional distribution. RESULTS: The attenuation constant for inflammatory granulation tissue was significantly higher than that for hyaline degeneration tissue (P < 0.001). Sound speed was high for granulation tissue, but tended to diminish gradually for hyaline degeneration. Sound speed increased again with progression to cystic degeneration (P < 0.001), but the attenuation constant remained low. When a cystic kidney contained a malignant lesion, the previously low attenuation constant rose at that site (P < 0.001), and the previously high sound speed was diminished (P < 0.001). CONCLUSION: Our data suggest that the physical properties of dialysed kidneys at different stages of pathology can be classified by their acoustic properties. Simultaneous evaluation of attenuation constant and sound speed is considered applicable to determining whether tissues contain malignant elements.
BACKGROUND: A correlation between acquired renal cysts in the dialysed kidney and renal cancer has long been debated, but no changes in the physical properties of kidneys at the microscopic level have been reported. The purpose of the present study was to classify the physical properties of the kidneys of patients undergoing haemodialysis at several stages of pathology by use of the scanning acoustic microscope. METHODS: Sixteen surgically excised kidneys of dialysis patients were investigated. Tissues were fixed in 10% formalin, frozen in acetone, and cut 10 microns thick on a cryostat. We used a scanning acoustic microscope operated in the frequency range of 100-200 MHz. Attenuation constant and sound speed were measured on a two-dimensional distribution. RESULTS: The attenuation constant for inflammatory granulation tissue was significantly higher than that for hyaline degeneration tissue (P < 0.001). Sound speed was high for granulation tissue, but tended to diminish gradually for hyaline degeneration. Sound speed increased again with progression to cystic degeneration (P < 0.001), but the attenuation constant remained low. When a cystic kidney contained a malignant lesion, the previously low attenuation constant rose at that site (P < 0.001), and the previously high sound speed was diminished (P < 0.001). CONCLUSION: Our data suggest that the physical properties of dialysed kidneys at different stages of pathology can be classified by their acoustic properties. Simultaneous evaluation of attenuation constant and sound speed is considered applicable to determining whether tissues contain malignant elements.