title: Color Doppler sonographic dynamic tissue perfusion measurement demonstrates significantly reduced cortical perfusion in children with diabetes mellitus type 1 without microalbuminuria and apparently healthy kidneys.
abstract: BACKGROUND
  With respect to the devastating consequences of the increasing prevalence of diabetes mellitus, the main reason for end stage renal disease and dialysis in industrialized countries, and the very limited diagnostic and therapeutic possibilities to predict, monitor and prevent diabetic nephropathy (DN), new concepts for early recognition and quantification of the prevailing microvascular changes in DN are urgently needed.
  
  
  METHODS
  We present the first study of renal cortical tissue perfusion measurement by means of standardized color Doppler sonographic videos evaluated with the PixelFlux software 1 for Dynamic Tissue Perfusion Measurement (DTPM) in 92 patients with DM1 without MA compared to 71 healthy probands.
  
  
  RESULTS
  DTPM reveals a highly significant diminution of cortical perfusion in patients with DM1 compared to healthy probands by 31 %, most pronounced in the distal hemicortex (reduction by 50 %) compared to 21 % within the proximal hemicortex.
  
  
  CONCLUSIONS
  Thus, DTPM offers a novel means of numerically describing the state of the renal microvasculature in DM in a patient-friendly, non-invasive, non-ionizing manner.
authors.forename: T M
authors.initials: TM
authors.lastname: Scholbach
authors.forename: C
authors.initials: C
authors.lastname: Vogel
authors.forename: N
authors.initials: N
authors.lastname: Bergner
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007672:Kidney Cortex / Q000098:blood supply*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D017060:Patient Satisfaction; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D012984:Software; D018615:Ultrasonography, Doppler, Color