Contrast-enhanced Sonography In The Diagnosis Of Delayed Graft Function

Objective To investigate the value of contrast-enhanced sonography (CEUS) in the diagnosis of delayed graft function.Methods A total of36kidney recipients underwent conventional US and CEUS examinations in14days after grafting.8patients had acute tubular necrosis (ATN group);23with normal evolution (as control group);3with acute rejection and2with renal infarction. Renal structure and volume were messured with two-dimensional ultrasound. US resistivity indexes (RI) and pulsatility indexes (PI) were obtained on main, infrarenal, and arcuate arteries while CEUS (SonoVue bolus injection) analysis was performed both on cortical and interlobar artery using time-intensity curve (TIC) software. The data of renal blood flow perfusion as Rise Time (RT), Time To Peak (TTP), maximum intensity (MAX), and cortical to interlobar artery ratio or difference of these indices were compared between three groups. RESULTS An increased RI was present in the ATN groups as well as a prolonged△RT and△TTP. The area under the ROC curve of△RT and△TTP increased from86.1%to97.8%compared with RI. The area of renal infarction can be detected by CEUS much more precisely than the examination by color Doppler. Conclusions Microcirulation perfusion changes of kidney grafts with ATN and AR could be detected by CEUS, wich might be superior in the diagnosis of ATN compared with conventional US.