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When is contrast-enhanced sonography preferable over conventional ultrasound combined with Doppler imaging in renal transplantation?

Zeisbrich M, Kihm LP, Drüschler F, Zeier M, Schwenger V - Clin Kidney J (2015)

Bottom Line: It is an easy to perform and non-invasive imaging technique that augments diagnostic capabilities in patients after renal transplantation.Specifically in the postoperative setting, CES has been shown to be superior to conventional ultrasound in combination with Doppler imaging in uncovering even subtle microvascular disturbances in the allograft perfusion.In addition, quantitative perfusion parameters derived from CES show predictive capability regarding long-term kidney function.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , University Hospital , Heidelberg , Germany.

ABSTRACT
Conventional ultrasound in combination with colour Doppler imaging is still the standard diagnostic procedure for patients after renal transplantation. However, while conventional ultrasound in combination with Doppler imaging can diagnose renal artery stenosis and vein thrombosis, it is not possible to display subtle microvascular tissue perfusion, which is crucial for the evaluation of acute and chronic allograft dysfunctions. In contrast, real-time contrast-enhanced sonography (CES) uses gas-filled microbubbles not only to visualize but also to quantify renal blood flow and perfusion even in the small renal arterioles and capillaries. It is an easy to perform and non-invasive imaging technique that augments diagnostic capabilities in patients after renal transplantation. Specifically in the postoperative setting, CES has been shown to be superior to conventional ultrasound in combination with Doppler imaging in uncovering even subtle microvascular disturbances in the allograft perfusion. In addition, quantitative perfusion parameters derived from CES show predictive capability regarding long-term kidney function.

No MeSH data available.


Related in: MedlinePlus

Qualitative assessment of contrast agent replenishment in a renal allograft visualized by CES mode. First, only large vessels at the renal hilum (arrow) are perfused (a). Gradually also small parenchymal vessels show contrast agent uptake (b and c) and present a homogeneous allograft perfusion (d).
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SFV070F1: Qualitative assessment of contrast agent replenishment in a renal allograft visualized by CES mode. First, only large vessels at the renal hilum (arrow) are perfused (a). Gradually also small parenchymal vessels show contrast agent uptake (b and c) and present a homogeneous allograft perfusion (d).

Mentions: In the evaluation of CES-derived data, it is useful to differentiate between the qualitative and the quantitative assessment. The qualitative assessment is based on the visible vascularization of parenchymal areas. This approach mainly provides morphological and anatomical information, e.g. the identification of areas with decreased tissue perfusion and the differentiation between benign cysts and vascularized lesions. This assessment is easy to perform and demands no special experience of the investigator (Figure 1).Fig. 1.


When is contrast-enhanced sonography preferable over conventional ultrasound combined with Doppler imaging in renal transplantation?

Zeisbrich M, Kihm LP, Drüschler F, Zeier M, Schwenger V - Clin Kidney J (2015)

Qualitative assessment of contrast agent replenishment in a renal allograft visualized by CES mode. First, only large vessels at the renal hilum (arrow) are perfused (a). Gradually also small parenchymal vessels show contrast agent uptake (b and c) and present a homogeneous allograft perfusion (d).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581388&req=5

SFV070F1: Qualitative assessment of contrast agent replenishment in a renal allograft visualized by CES mode. First, only large vessels at the renal hilum (arrow) are perfused (a). Gradually also small parenchymal vessels show contrast agent uptake (b and c) and present a homogeneous allograft perfusion (d).
Mentions: In the evaluation of CES-derived data, it is useful to differentiate between the qualitative and the quantitative assessment. The qualitative assessment is based on the visible vascularization of parenchymal areas. This approach mainly provides morphological and anatomical information, e.g. the identification of areas with decreased tissue perfusion and the differentiation between benign cysts and vascularized lesions. This assessment is easy to perform and demands no special experience of the investigator (Figure 1).Fig. 1.

Bottom Line: It is an easy to perform and non-invasive imaging technique that augments diagnostic capabilities in patients after renal transplantation.Specifically in the postoperative setting, CES has been shown to be superior to conventional ultrasound in combination with Doppler imaging in uncovering even subtle microvascular disturbances in the allograft perfusion.In addition, quantitative perfusion parameters derived from CES show predictive capability regarding long-term kidney function.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , University Hospital , Heidelberg , Germany.

ABSTRACT
Conventional ultrasound in combination with colour Doppler imaging is still the standard diagnostic procedure for patients after renal transplantation. However, while conventional ultrasound in combination with Doppler imaging can diagnose renal artery stenosis and vein thrombosis, it is not possible to display subtle microvascular tissue perfusion, which is crucial for the evaluation of acute and chronic allograft dysfunctions. In contrast, real-time contrast-enhanced sonography (CES) uses gas-filled microbubbles not only to visualize but also to quantify renal blood flow and perfusion even in the small renal arterioles and capillaries. It is an easy to perform and non-invasive imaging technique that augments diagnostic capabilities in patients after renal transplantation. Specifically in the postoperative setting, CES has been shown to be superior to conventional ultrasound in combination with Doppler imaging in uncovering even subtle microvascular disturbances in the allograft perfusion. In addition, quantitative perfusion parameters derived from CES show predictive capability regarding long-term kidney function.

No MeSH data available.


Related in: MedlinePlus