Contrast-enhanced Ultrasonography In Diagnosis Of Early Kidney Allograft Dysfunction After Transplantation

Objectives.Compare the value of contrast-enhanced ultrasonography (CEUS) with conventional color Doppler ultrasonography (CDUS) in diagnosis of early kidney allograft dysfunction after transplantation.Methods:A total of 84 kidney transplant recipients underwent CEUS and CDUS examination within 2 weeks after grafting.73 patients had normal kidney function (control group).11 patients with early kidney dysfunction were classified as acute tubular necrosis (ATN group, n=7) and acute rejection episodes (ARE group, n=4) according to clinical data and Banff criteria. Resistivity indexes (RI) and pulse indexes (PI) on main, interlobar, infrarenal and arcuate arteries were determined in CDUS. CEUS time-intensity curves (TIC) of interlobar arteries and cortical regions were obtained through sonolive software, and time to peak (TTP), rise time (RT) and their differences between the two regions (ART andATTP) were computed.Results.Both ART and ATTP in ATN group and ARE group were significantly longer than that of control group. In ATN group, the area under receiver operating characteristic (ROC) curve performed for ART and ATTP were 0.926 and 0.932, which were significantly larger than 0.885 and 0.889 performed for RI and PI. In ARE group, the area under ROC curve performed for△RT and△TTP were 0.969 and 0.945, which were similar with 0.971 and 0.942 performed for RI and PI.Conclusion.CEUS TIC analysis objectively reflects kidney allograft perfusion, and it is superior in diagnosis of acute tubular necrosis while is resemble in diagnosis of acute rejection episodes comparing to RI and PI in patients with early kidney allograft dysfunction.