title: Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced CT. A feasibility study.
abstract: The effectiveness of contrast-enhanced ultrasonography (CEUS) in the evaluation of patients with acute renal infarcts was investigated, using contrast-enhanced helical computed tomography (CT) as the reference imaging procedure. Twenty-seven consecutive patients with acute renal infarcts detected with contrast-enhanced helical CT underwent CEUS. Digital cine-clips of CEUS were evaluated by two independent readers blinded to CT findings. Image quality was rated subjectively on a four-point scale. Then, readers were asked to assign a confidence level in diagnosis of renal infarct at the upper pole, medium portion, and lower pole of each kidney according to a five-degree scale, ranging from definitely absent to definitely present. ROC curve analysis was employed to assess the overall confidence of diagnosis of infarct, and weighted kappa values were calculated to assess inter-reader agreement. The subjective image quality of CEUS was lower than the image quality of CT at the upper poles. However, the diagnostic performance of CEUS was excellent (area under receiver-operator characteristic curve 0.992 +/- 0.006 for reader 1; 0.991 +/- 0.007 for reader 2), with very good inter-reader agreement (weighted kappa value = 0.83). CEUS is a reproducible tool to detect acute renal infarcts in men, with a diagnostic performance approaching that of CT.
authors.affiliation: UCO di Radiologia, Università di Trieste, Ospedale di Cattinara, Strada di Fiume 449, 34149 Trieste, Italy. bertolot@units.it
authors.forename: Michele
authors.initials: M
authors.lastname: Bertolotto
authors.forename: Alberto
authors.initials: A
authors.lastname: Martegani
authors.forename: Luca
authors.initials: L
authors.lastname: Aiani
authors.forename: Roberta
authors.initials: R
authors.lastname: Zappetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Cernic
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Cova
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007238:Infarction / Q000175:diagnosis*; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D015588:Observer Variation; D010743:Phospholipids; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D036542:Tomography, Spiral Computed / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride