Functional study of the transplanted kidney with power Doppler US and time/intensity curves.
OBJECTIVE
Power Doppler ultrasound (US) with time-intensity curves was used to study renal graft function both in the absence of disease and with complications (acute tubular necrosis and chronic rejection) in an attempt to identify pathognomonic patterns. Time-intensity curves allow representation of the kidneys' wash-in and wash-out phases after intravenous administration of sonographic contrast material.


METHODS
Fifty-six asymptomatic renal transplant patients (36 men and 20 women), 19 of whom had altered creatinine clearance levels, were studied by power Doppler US with time-intensity curves followed by biopsy. Ten asymptomatic patients with normal creatinine clearance levels were used as controls.


RESULTS
Time-intensity curve analysis enabled identification of three groups of patients: group A, consisting of 27 patients showing peak enhancement between 50 and 65 s from intravenous administration of contrast material; group B, consisting of 16 patients with peak enhancement between 135 and 235 s; group C, consisting of three patients with peak enhancement between 100 and 130 s.


CONCLUSIONS
Data showed significant variations according to renal graft function (no abnormality, acute tubular necrosis or chronic rejection). Although confirmation by a larger series is required, our findings appear to indicate pathognomonic patterns in patients with chronic rejection and acute tubular necrosis.
Farina
R
R
Istituto di Radiologia, Policlinico Universitario di Catania, Via S. Sofia 89, I-95125 Catania, Italy. radfaro@hotmail.com
Pennisi
F
F
La Rosa
M
M
Puglisi
C
C
Di Benedetto
A
A
Campisi
G
G
Mazzone
G
G
Ettorre
G C
GC
D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D003287:Contrast Media; D003404:Creatinine / Q000652:urine; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D016030:Kidney Transplantation / Q000000981:diagnostic imaging* / Q000502:physiology; D007683:Kidney Tubular Necrosis, Acute / Q000000981:diagnostic imaging; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors; D018608:Ultrasonography, Doppler; D018616:Ultrasonography, Doppler, Duplex
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D003404:Creatinine