Real-Time Contrast-Enhanced Sonography of Renal Transplant Recipients Predicts Chronic Allograft Nephropathy

Authors: Schwenger, V.; Korosoglou, G.; Hinkel, U.-P.¹; Morath, C.¹; Hansen, A.²; Sommerer, C.¹; Dikow, R.¹; Hardt, S.²; Schmidt, J.³; Kücherer, H.²; Katus, H.A.²; Zeier, M.

Source: American Journal of Transplantation, Volume 6, Number 3, March 2006 , pp. 609-615(7)

Publisher: Wiley-Blackwell

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Abstract:

Real-time contrast-enhanced sonography (RT-CES) can assess microvascular tissue perfusion using gas-filled microbubbles. The study was performed to evaluate the feasibility of RT-CES in detecting chronic allograft nephropathy (CAN) in comparison to color Doppler ultrasonography (CDUS). A total of 26 consecutive renal transplant recipients were prospectively studied using RT-CES and conventional CDUS. Transplant tissue perfusion imaging was performed by low-power imaging during i.v. administration of the sonocontrast Optison™. Renal tissue perfusion was assessed quantitatively using flash replenishment kinetics of microbubbles to estimate renal blood flow A *β (A = peak signal intensity, β= slope of signal intensity rise). In contrast to conventional CDUS resistance and pulsatility indices, renal blood flow estimated by CES was highly significant related to S-creatinine (r =–0.62, p = 0.0004). Determination of renal blood flow by CES reached a higher sensitivity (91% vs. 82%, p < 0.05), specificity (82% vs. 64%, p < 0.05) and accuracy (85% vs. 73%, p < 0.05) for the diagnosis of CAN as compared to conventional CDUS resistance indices. Perfusion parameters derived from RT-CES significantly improve the early detection of CAN compared to conventional CDUS. RT-CES using low-power real-time perfusion imaging is a feasible method to evaluate microvascular perfusion in renal allograft recipients.

Keywords: Chronic allograft nephropathy; real-time contrast-enhanced sonography; renal allograft; resistance index

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1600-6143.2005.01224.x

Affiliations: 1: Nephrology 2: Cardiology 3: General and Transplant Surgery, University of Heidelberg, Germany

Publication date: 2006-03-01

Real-Time Contrast-Enhanced Sonography of Renal Transplant Recipients Predicts Chronic Allograft Nephropathy

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