The diagnostic value of contrast-enhanced ultrasonography in the assessment of perirenal hematomas in the early post-operative period after kidney transplantation

Background Routine B‐mode ultrasound examination (rB‐US) is a current standard for the assessment of the transplanted kidney(KTx) in the early post‐operative period. The alteration of perirenal hematoma (PH) echostructure over time limits their detectability and size assessment with rB‐US. The aim o...

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Published in:Clinical transplantation 2013-11, Vol.27 (6), p.E619-E624
Main Authors: Grzelak, P., Kurnatowska, I., Nowicki, M., Strzelczyk, J., Durczyński, A., Podgórski, M., Stefańczyk, L.
Format: Article
Language:English
Subjects:
Adult
Aged
Contrast Media
contrast-enhanced ultrasonography
Female
Follow-Up Studies
Graft Rejection - diagnostic imaging
Graft Rejection - etiology
Hematoma - diagnostic imaging
Humans
Kidney Failure, Chronic - diagnostic imaging
kidney graft
Kidney Transplantation
Male
Middle Aged
perirenal hematoma
Postoperative Complications
Postoperative Period
Prognosis
Ultrasonography
Young Adult
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Summary:Background Routine B‐mode ultrasound examination (rB‐US) is a current standard for the assessment of the transplanted kidney(KTx) in the early post‐operative period. The alteration of perirenal hematoma (PH) echostructure over time limits their detectability and size assessment with rB‐US. The aim of this study was to evaluate the diagnostic value of contrast‐enhanced ultrasound (CE‐US) in diagnosing PH of KTx in the early post‐operative period. Method Routine B‐US and CE‐US of KTx, performed in 102 patients in the early post‐operative period, were analyzed. CE‐US was performed after intravenous administration of 2.4 mL of sulfur hexafluoride solution. The data were analyzed with respect to the occurrence and thickness of PH. Result The difference in echogenicity between PH and kidney parenchyma was modest in rB‐US (mean of 5.7 dB). However, in CE‐US, the difference in echogenicity was significantly increased (mean of 31.4 dB). Routine B‐US did not allow PH to be recognized in 18 patients. The application of CE‐US results in a twofold increase in PH detection when compared with rB‐US (33.3% vs. 15.7%). Conclusion US‐CE examination is a valuable method for detection and assessment of PH size. Compared with rB‐US, this technique may substantially increase the detectability of hemorrhagic complications in the direct post‐operative period.
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.12257