Application Of Contrast-enhanced Ultrasound In The Quantitative Study Of Transplanted Kidney's Perfusion

Objective: To approach the ideal dose of SonoVue and the most appropriate positions of ROI in CPI examination of transplanted kidney, and to study the appearances of CEUS in subjects with stable functional condition and with complications after renal transplantation.Methods:⑴.Each of fifteen homoioplastic subjects in stable functional condition after renal transplantation was examined using Logiq 9 Color Doppler Ultrasonograph after intravenous bolus administration of 1.2ml,1.4ml and 1.6ml of SonoVue, the CPI sonogram, TIC and curvilinear indexes derived from the Sonoliver TIC analysis software were compared to find out ideal dose of SonoVue and most suitable positions of ROI in the cortex and medulla.⑵.Thirty subjects in stable functional condition were examined after intravenous bolus administration of 1.4ml of SonoVue in order to evaluate the characteristics appearance of CPI sonogram, TIC and curvilinear indexes derived from Sonoliver in the middle territory of cortex and medulla.⑶.Subjects with abnormal clinical symptoms who were about to perform renal biopsy were examined after intravenous bolus administration of 1.4ml of SonoVue, and grouped according to the pathological results.The characteristics appearance of CPI sonogram, TIC and the curvilinear indexes derived from Sonoliver in the middle territory of cortex and medulla were sequencely evaluated.Results:⑴. The visualization quality and QOF of 1.4ml and 1.6ml surpassed those of 1.2ml(P<0.05),the RT, mTT, TTP of 1.2ml were significant shorter to those of 1.6ml(P<0.05), and the visualization quality and curvilinear indexes of 1.4ml paralleled those of 1.6ml(P>0.05).Besides, curvilinear indexes from different ROIs in cortex and medulla that received 1.4ml SonoVue were similar(P>0.05).⑵.The subjects in stable functional condition after intravenous bolus administration of 1.4ml of SonoVue had a uniform CPI appearance: contrast agent showed up early and developed gradually following arteries, then enhanced cortex from the bottom of the pyramids to capsular surface, and sequencely embraced the pyramids followed by a washout and plateau phase. The enhancement in the cortex was faster than that in the pyramid; the TIC was a positive skewness curve with double peaks and one trough, and the first peak was higher and acuter; the curvilinear indexes of renal artery, cortex, the whole kidney and medulla manifested unequal gradients.⑶.When subjects appeared complications, the visualization of kidney, the distinctness of kidney's outline, the uniformity of contrast agent degraded, perfuse time and empty time prolonged; besides, the TIC waved accompanied a lower or disappear second peak.Conclusions:⑴.The ideal dose of SonVue in CPI examination of transplanted kidney is 1.4ml, and the most appropriate positions of ROI in cortex and medulla are the middle territories.⑵.The transplanted kidney in stable functional condition has high quality of CEUS appearance and TIC, and the curvilinear indexes of renal artery, cortex, the whole kidney and medulla manifest unequal gradients.⑶when kidney shows up some complications, the quality of CEUS appearance and TIC degrade, curvilinear indexes prolong. The CPI associates with Sonoliver TIC analysis software has showed up initial prospective in earlier diagnosis and differential diagnosis of complications.