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

• 作者: Chiara Zuiani Gian Luigi Adani Giuseppe Como Jacopo Da Re Rossano Girometti
• 来源期刊: 世界放射学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Contrast-enhanced ultrasound Kidney transplant Post-renal transplant complications Graft function Ultrasound contrast agents
• 年，卷（期）: 2020,（8）
• 页码范围: 156-171
• 页数: 16页
• 分类号: R73

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.