title: Perfusion disturbances of kidney graft parenchyma evaluated with contrast-enhanced ultrasonography in the immediate period following kidney transplantation.
abstract: OBJECTIVE
  Graft parenchyma perfusion disturbances (GPPD) in transplanted kidneys are common in the early postoperative period. Rapid and accurate diagnosis can guide proper treatment, preventing graft dysfunction.
  
  
  METHODS
  One hundred and eighty patients, who underwent kidney transplantation (KTx), were examined in the immediate postoperative period using real-time ultrasonography (B-mode) with color and power Doppler (US-CD/PD) and B-flow ultrasound, as well as with an additional protocol of contrast-enhanced ultrasonography (CE-US). Regions of GPPD were localized and measured. The number and size of these areas were compared between the two acquisition techniques. Follow-up examinations were carried out 6 months postoperatively.
  
  
  RESULTS
  CE-US revealed more GPPDs and showed them more precisely than the B+US-CD/PD/B-flow technique. Moreover, in the CE-US examination, ischemic foci had statistically significant higher echogenicity in comparison to normal parenchyma, were larger and better visualized (better circumscribed) than in B+US-CD/PD/B-flow.
  
  
  CONCLUSIONS
  CE-US allows the visualization of GPPD caused by occlusion of small arteries. It is a noninvasive, safe, real-time method, which has many advantages over standard B+US-CD/PD/B-flow examinations, and we recommend it as a routine diagnostic procedure in the early postoperative period following KTx.
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: M
authors.initials: M
authors.lastname: Marchwicka-Wasiak
authors.forename: M
authors.initials: M
authors.lastname: Podgórski
authors.forename: A
authors.initials: A
authors.lastname: Durczyński
authors.forename: J
authors.initials: J
authors.lastname: Strzelczyk
authors.forename: L
authors.initials: L
authors.lastname: Stefańczyk
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D003287:Contrast Media