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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

Screenshot of the analysing software for the quantitative assessment. The upper screen shows on the left side an image from CES mode and on the right from B-mode. The red labelled area is the ROI, which should exclude major vessels and the peripheral ending of the cortex. The lower half of the screen displays the corresponding destruction–replenishment curve. The y-axis indicates the contrast intensity (dB) and the x-axis indicates time (s).
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SFV070F2: Screenshot of the analysing software for the quantitative assessment. The upper screen shows on the left side an image from CES mode and on the right from B-mode. The red labelled area is the ROI, which should exclude major vessels and the peripheral ending of the cortex. The lower half of the screen displays the corresponding destruction–replenishment curve. The y-axis indicates the contrast intensity (dB) and the x-axis indicates time (s).

Mentions: However, the quantitative assessment is conducted via computer after the patients' examination. It requires a specific analysing software and basic experience in the handling of it. The quantitative assessment is a haemodynamic approach to evaluate parenchymal microperfusion. For that, it is necessary to measure blood flow velocity and blood flow volume, which is realized by destruction–replenishment technique. A single flash of ultrasound with high transmission power destroys the microbubbles [21]. After clearance of microbubbles, the replenishment of the contrast agent in the allograft and the changes in echogenicity can be followed and evaluated in a predefined region of interest (ROI). The analysing software then calculates a time/intensity curve to estimate renal blood flow (in dB/s) (Figure 2).Fig. 2.


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)

Screenshot of the analysing software for the quantitative assessment. The upper screen shows on the left side an image from CES mode and on the right from B-mode. The red labelled area is the ROI, which should exclude major vessels and the peripheral ending of the cortex. The lower half of the screen displays the corresponding destruction–replenishment curve. The y-axis indicates the contrast intensity (dB) and the x-axis indicates time (s).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

SFV070F2: Screenshot of the analysing software for the quantitative assessment. The upper screen shows on the left side an image from CES mode and on the right from B-mode. The red labelled area is the ROI, which should exclude major vessels and the peripheral ending of the cortex. The lower half of the screen displays the corresponding destruction–replenishment curve. The y-axis indicates the contrast intensity (dB) and the x-axis indicates time (s).
Mentions: However, the quantitative assessment is conducted via computer after the patients' examination. It requires a specific analysing software and basic experience in the handling of it. The quantitative assessment is a haemodynamic approach to evaluate parenchymal microperfusion. For that, it is necessary to measure blood flow velocity and blood flow volume, which is realized by destruction–replenishment technique. A single flash of ultrasound with high transmission power destroys the microbubbles [21]. After clearance of microbubbles, the replenishment of the contrast agent in the allograft and the changes in echogenicity can be followed and evaluated in a predefined region of interest (ROI). The analysing software then calculates a time/intensity curve to estimate renal blood flow (in dB/s) (Figure 2).Fig. 2.

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