title: Perfusion of kidney graft pyramids and cortex in contrast-enhanced ultrasonography in the determination of the cause of delayed graft function.
abstract: BACKGROUND
  The aim of this study was to assess the usefulness of a new ultrasound technique - contrast-enhanced ultrasound examination (US-CE) - using sulphur hexafluoride in the early post-transplant assessment of graft perfusion. Time-intensity curves (TIC) were compared with hemodynamic flow parameters (resistive index: RI) in patients with good early graft function (EGF) and acute rejection (AR) or acute tubular necrosis (ATN) as a cause of delayed graft function (DGF).
  
  
  METHODS
  US-CE was conducted in order to assess graft perfusion in the early period after kidney transplantation (72-120 hours) in 63 kidney allograft recipients: 35 with EGF and 28 with DGF. The DGF patients were later diagnosed based on graft biopsy as AR (n = 10) or ATN (n = 18). Time-intensity curves were compared with hemodynamic flow parameters typically assessed in post-operative graft diagnostics (e.g., RI).
  
  
  RESULTS
  In the examination with US-CE in EGF patients, the regular inflow of contrast medium was demonstrated in all regions of the graft. In patients with DGF, a delay in the inflow of the contrast medium was observed, as well as significant differences in the time of inflow to the regions of interest between those 2 groups. There was a significantly longer inflow time of the contrast medium to the cortex and renal pyramids in patients with AR than in ATN recipients.
  
  
  CONCLUSIONS
  US-CE may be a valuable diagnostic tool in the determination of the cause of DGF.
authors: Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Lodz, Poland.
authors: Piotr
authors: P
authors: Grzelak
authors: Konrad
authors: K
authors: Szymczyk
authors: Janusz
authors: J
authors: Strzelczyk
authors: Ilona
authors: I
authors: Kurnatowska
authors: Michal
authors: M
authors: Sapieha
authors: Michal
authors: M
authors: Nowicki
authors: Ludomir
authors: L
authors: Stefanczyk
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D051799:Delayed Graft Function / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging* / Q000502:physiology*; D007683:Kidney Tubular Necrosis, Acute / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation; D014463:Ultrasonography
chemical_list: D003287:Contrast Media