title: Disturbances of kidney graft perfusion as indicators of acute renal vein thrombosis in contrast-enhanced ultrasonography.
abstract: BACKGROUND
  The aim of this study was to evaluate the usefulness of contrast-enhanced ultrasound (US-CE) to diagnose acute renal vein thrombosis (ARVT), acute rejection episodes (ARE), or acute tubular necrosis (ATN) in kidney grafts.
  
  
  METHODS
  We analyzed 171 US-CE among kidney transplantation patients in the early postoperative period. Patients underwent US-CE following a standard diagnostic protocol including real-time ultrasound (B-mode) and color Doppler ultrasound with spectral flow analysis. Tissue perfusion was analyzed based upon time-intensity curves for two regions: the renal cortex and the renal pyramids.
  
  
  RESULTS
  Of 14 patients, in whom standard ultrasound showed high resistance parameters in the renal artery, three showed ARVT and 11 had ATN or ARE, which were confirmed by biopsy. Among patients with ARVT, the US-CE showed a lack of contrast perfusion into the cortex and renal pyramids. Patients with ARE/ATN showed slower contrast inflow into the parenchyma with reduced but still present perfusion. The differences in mean signal intensity values were significant for both the cortex and the renal pyramids: cortex: -53.8±5.4 dB versus -35.0±3.5 dB (P<.05) and pyramids: -54.8±5.4 dB versus -37.0±3.5 dB (P<.05).
  
  
  CONCLUSIONS
  US-CE is a noninvasive method that provides easy, reliable differentiation of ARVT from ARE/ATN.
authors: Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland.
authors: P
authors: P
authors: Grzelak
authors: I
authors: I
authors: Kurnatowska
authors: M
authors: M
authors: Sapieha
authors: M
authors: M
authors: Nowicki
authors: J
authors: J
authors: Strzelczyk
authors: M E
authors: ME
authors: Nowicki
authors: L
authors: L
authors: Stefańczyk
mesh_terms: D000328:Adult; D003287:Contrast Media; D006084:Graft Rejection / Q000000981:diagnostic imaging; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D007683:Kidney Tubular Necrosis, Acute / Q000000981:diagnostic imaging; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology*; D012079:Renal Circulation; D012082:Renal Veins / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*
chemical_list: D003287:Contrast Media