ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2021, Vol. 30 ›› Issue (1): 43-48.DOI: 10.3969/j.issn.1006298X.2021.01.008

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Contrast-enhanced ultrasonography for diagnosis and therapeutic effect monitoring of transplant renal artery stenosis

  

  • Online:2021-02-28 Published:2021-02-27

Abstract: Objective:To explore the application of quantitative analysis of contrastenhanced ultrasound (CEUS) for diagnosis and therapeutic effect monitoring in adult patients with transplant renal artery stenosis (TRAS).
Methodology:34 patients who were considered as TRAS after renal transplantation in our hospital were selected. The diagnosis was confirmed by computed tomography angiography (CTA), patients were divided into TRAS group (n=18) and control group (n=16). The clinical data and ultrasonic parameters of the two groups were analyzed retrospectively.
Results:TRAS was diagnosed by CEUS in 18 cases,of which 16 cases were confirmed by CTA at the same time. The sensitivity and specificity of CEUS in the diagnosis of TRAS were 889% and 875%. CEUS quantitative analysis showed that the time to peak,absolutely time to peak and meantransit time in TRAS group were prolonged,the area under the curve increased,and negatively correlated with estimated glomerular filtration rate (P<0001). 8 patients in TRAS group underwent vascular intervention because of severe stenosis and poor microcirculation perfusion of transplanted kidney,CEUS parameters improved after operation. While CEUS revealed good microcirculation perfusion of the graft in the other 10 patients and they received conservative therapies only. During the followup of more than 12 months,all the patients had relative good renal allograft perfusion and stable renal function.
Conclusion:CEUS can directly evaluate the degree of TRAS  and quantitatively analyze the microcirculation perfusion of transplanted kidney.It is a reliable method for auxiliary diagnosis and followup the therapeutic effect of TRAS.


Key words: transplant renal artery stenosis, contrast-enhanced ultrasound, blood perfusion, diagnosis, therapeutic effect