Role for contrast-enhanced ultrasound in assessing complications after kidney transplant

被引:13
作者
Como, Giuseppe [1 ]
Da Re, Jacopo [2 ]
Adani, Gian Luigi [3 ]
Zuiani, Chiara [2 ]
Girometti, Rossano [2 ]
机构
[1] Univ Hosp S Maria Misericordia, Inst Radiol, I-33100 Udine, Italy
[2] Univ Udine, Univ Hosp S Maria Misericordia, Dept Med, Inst Radiol, 15 Ple Santa Maria Misericordia, I-33100 Udine, Italy
[3] Univ Hosp S Maria Misericordia, Dept Med Gen Surg & Transplantat, I-33100 Udine, Italy
关键词
Contrast-enhanced ultrasound; Kidney transplant; Post-renal transplant complications; Graft function; Ultrasound contrast agents; RENAL-ARTERY STENOSIS; ACUTE GRAFT PYELONEPHRITIS; SURGICAL COMPLICATIONS; VASCULAR COMPLICATIONS; CORTICAL NECROSIS; DIAGNOSTIC-VALUE; RISK-FACTORS; ULTRASONOGRAPHY; CEUS; EPIDEMIOLOGY;
D O I
10.4329/wjr.v12.i8.156
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Kidney transplantation (KT) is an effective treatment for end-stage renal disease. Despite their rate has reduced over time, post-transplant complications still represent a major clinical problem because of the associated risk of graft failure and loss. Thus, post-KT complications should be diagnosed and treated promptly. Imaging plays a pivotal role in this setting. Grayscale ultrasound (US) with color Doppler analysis is the first-line imaging modality for assessing complications, although many findings lack specificity. When performed by experienced operators, contrast-enhanced US (CEUS) has been advocated as a safe and fast tool to improve the accuracy of US. Also, when performing CEUS there is potentially no need for further imaging, such as contrast-enhanced computed tomography or magnetic resonance imaging, which are often contraindicated in recipients with impaired renal function. This technique is also portable to patients' bedside, thus having the potential of maximizing the cost-effectiveness of the whole diagnostic process. Finally, the use of blood-pool contrast agents allows translating information on graft microvasculature into time-intensity curves, and in turn quantitative perfusion indexes. Quantitative analysis is under evaluation as a tool to diagnose rejection or other causes of graft dysfunction. In this paper, we review and illustrate the indications to CEUS in the post-KT setting, as well as the main CEUS findings that can help establishing the diagnosis and planning the most adequate treatment.
引用
收藏
页码:156 / 171
页数:16
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