title: The diagnostic value of contrast-enhanced ultrasonography in the assessment of perirenal hematomas in the early post-operative period after kidney transplantation.
abstract: BACKGROUND
  Routine B-mode ultrasound examination (rB-US) is a current standard for the assessment of the transplanted kidney(KTx) in the early post-operative period. The alteration of perirenal hematoma (PH) echostructure over time limits their detectability and size assessment with rB-US. The aim of this study was to evaluate the diagnostic value of contrast-enhanced ultrasound (CE-US) in diagnosing PH of KTx in the early post-operative period.
  
  
  METHODS
  Routine B-US and CE-US of KTx, performed in 102 patients in the early post-operative period, were analyzed. CE-US was performed after intravenous administration of 2.4 mL of sulfur hexafluoride solution. The data were analyzed with respect to the occurrence and thickness of PH.
  
  
  RESULTS
  The difference in echogenicity between PH and kidney parenchyma was modest in rB-US (mean of 5.7 dB). However, in CE-US, the difference in echogenicity was significantly increased (mean of 31.4 dB). Routine B-US did not allow PH to be recognized in 18 patients. The application of CE-US results in a twofold increase in PH detection when compared with rB-US (33.3% vs. 15.7%).
  
  
  CONCLUSIONS
  US-CE examination is a valuable method for detection and assessment of PH size. Compared with rB-US, this technique may substantially increase the detectability of hemorrhagic complications in the direct post-operative period.
authors.affiliation: Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Lodz, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Grzelak
authors.forename: I
authors.initials: I
authors.lastname: Kurnatowska
authors.forename: M
authors.initials: M
authors.lastname: Nowicki
authors.forename: J
authors.initials: J
authors.lastname: Strzelczyk
authors.forename: A
authors.initials: A
authors.lastname: Durczyński
authors.forename: M
authors.initials: M
authors.lastname: Podgórski
authors.forename: L
authors.initials: L
authors.lastname: Stefańczyk
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology; D006406:Hematoma / Q000000981:diagnostic imaging*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: contrast-enhanced ultrasonography; kidney graft; perirenal hematoma