Florin Ioan Elec1, Alina Daciana Elec2, Sorana Bolboaca3, Mihai Adrian Socaciu4, Adriana Milena Muntean5, Gheorghiță Iacob6, Tudor Moisoiu7, Răzvan Zaro8, Alexandra-Ioana Andries9, Maria Ramona Badulescu10, Radu Mihai Ignat11, Radu Ion Badea12. 1. Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania; Dpt. of Urology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;. ioan.elec@gmail.com. 2. Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania;. dralinaelec@gmail.com. 3. Dpt. of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. sbolboaca@gmail.com. 4. Dpt.of Medical Imaging, Regional Institute of Gastroenterology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania; Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;. mihaiaso@gmail.com. 5. Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania;. munteana2@yahoo.com. 6. Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania;. iacob.gheorghita@gmail.com. 7. Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romaniaș Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania;. tmoisoiu@gmail.com. 8. Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. razvanzaro@yahoo.com. 9. Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;. alexandra.andries.ioana@gmail.com. 10. Dpt. of Urology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. ramona.contis@gmail.com. 11. Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Dpt.of Anatomy, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;. radu.mihai.ignat@gmail.com. 12. Dpt.of Medical Imaging, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Dpt.of Medical Imaging, Regional Institute of Gastroenterology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania;. rbadea2012@gmail.com.
Abstract
AIM: Our study aimed to assess the usefulness of contrast-enhanced ultrasound (CEUS) in the initial evaluation of the graft function. MATERIALS AND METHOD: A cross-sectional study was conducted in the early postoperative period on patients with kidney transplantation, between September 2017 to November 2018. Two groups of patients were investigated; delayed graft function (DGF) and early graft function (EGF). All patients were examined by grey scale, Doppler ultrasound and CEUS. RESULTS: Nineteen patients, aged from 23 to 64 years (mean age 50 years), 7 in the DGF group and 12 in the EGF group were evaluated. The resistive index (RI) show significantly higher values in the DGF group at the level of upper interlobar artery (p=0.025) and medium interlobar artery (p=0.02). The CEUS investigation shows a greater region of interest (ROI) area (p=0.02) and lower values for wash-out area under the curve (WoAUC) (p=0.047) and respectively wash-in and wash-out area under the curve (WiWoAUC) (p=0.031) for the DGF group. The quality of fit (QoF) proved lower in the DGF group either for evaluation of global graft (p=0.012), cortex (p=0.025), or medulla (p=0.009).A significant relationship among all patients was found between the glomerular filtration rate (GFR) [ml/min] and the renal artery fall time (FT) [s] (p=0.012), WoAUC [a.u.] (p=0.03), and WiWoAUC [a.u.] (p=0.024). The arterial QoF [%] was associated with the arterial ROI area (p=0.048). CONCLUSIONS: Intensity CEUS parameters WoAUC and WiWoAUC may be useful to diagnose and follow-up grafts with delayed function. Additional studies on larger cohorts are required for the recommendation of CEUS as a routine evaluation of the transplanted kidney.
AIM: Our study aimed to assess the usefulness of contrast-enhanced ultrasound (CEUS) in the initial evaluation of the graft function. MATERIALS AND METHOD: A cross-sectional study was conducted in the early postoperative period on patients with kidney transplantation, between September 2017 to November 2018. Two groups of patients were investigated; delayed graft function (DGF) and early graft function (EGF). All patients were examined by grey scale, Doppler ultrasound and CEUS. RESULTS: Nineteen patients, aged from 23 to 64 years (mean age 50 years), 7 in the DGF group and 12 in the EGF group were evaluated. The resistive index (RI) show significantly higher values in the DGF group at the level of upper interlobar artery (p=0.025) and medium interlobar artery (p=0.02). The CEUS investigation shows a greater region of interest (ROI) area (p=0.02) and lower values for wash-out area under the curve (WoAUC) (p=0.047) and respectively wash-in and wash-out area under the curve (WiWoAUC) (p=0.031) for the DGF group. The quality of fit (QoF) proved lower in the DGF group either for evaluation of global graft (p=0.012), cortex (p=0.025), or medulla (p=0.009).A significant relationship among all patients was found between the glomerular filtration rate (GFR) [ml/min] and the renal artery fall time (FT) [s] (p=0.012), WoAUC [a.u.] (p=0.03), and WiWoAUC [a.u.] (p=0.024). The arterial QoF [%] was associated with the arterial ROI area (p=0.048). CONCLUSIONS: Intensity CEUS parameters WoAUC and WiWoAUC may be useful to diagnose and follow-up grafts with delayed function. Additional studies on larger cohorts are required for the recommendation of CEUS as a routine evaluation of the transplanted kidney.