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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

(A) Perfusion of a kidney allograft visualized by power Doppler ultrasound shows a vascular disturbance at the caudal pole (delineated by × and +). (B) Same allograft examined with CES. (a) B-mode image of the caudal renal pole; (b) CES examination reveals a homogenous microvascular perfusion without any disturbances.
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SFV070F4: (A) Perfusion of a kidney allograft visualized by power Doppler ultrasound shows a vascular disturbance at the caudal pole (delineated by × and +). (B) Same allograft examined with CES. (a) B-mode image of the caudal renal pole; (b) CES examination reveals a homogenous microvascular perfusion without any disturbances.

Mentions: Conversely, with colour Doppler, it is sometimes not possible to evaluate if a visualized vascular disturbance like a reduced perfusion of one renal pole is significant or due to technical limitations. It is known that diagnostic findings in Doppler ultrasound are limited when the allograft lies deep within the iliac fossa [33]. In these cases, CES can differentiate between a real and an apparent perfusion defect and spares a further examination by MRI or CT (Figure 4).Fig. 4.


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)

(A) Perfusion of a kidney allograft visualized by power Doppler ultrasound shows a vascular disturbance at the caudal pole (delineated by × and +). (B) Same allograft examined with CES. (a) B-mode image of the caudal renal pole; (b) CES examination reveals a homogenous microvascular perfusion without any disturbances.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

SFV070F4: (A) Perfusion of a kidney allograft visualized by power Doppler ultrasound shows a vascular disturbance at the caudal pole (delineated by × and +). (B) Same allograft examined with CES. (a) B-mode image of the caudal renal pole; (b) CES examination reveals a homogenous microvascular perfusion without any disturbances.
Mentions: Conversely, with colour Doppler, it is sometimes not possible to evaluate if a visualized vascular disturbance like a reduced perfusion of one renal pole is significant or due to technical limitations. It is known that diagnostic findings in Doppler ultrasound are limited when the allograft lies deep within the iliac fossa [33]. In these cases, CES can differentiate between a real and an apparent perfusion defect and spares a further examination by MRI or CT (Figure 4).Fig. 4.

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