Quantitative assessment of renal perfusion in children with UPJO by contrast enhanced ultrasound: A pilot study

Chen, Shuofan; Lin, Defu; Liu, Pei; Sun, Ning; Han, Wei; Li, Minglei; Zhang, Weiping; Song, Hongcheng; Li, Zhenwu; Liu, Qinglin; Wang, Xiaoman

doi:10.1016/j.jpurol.2021.11.004

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…The study group investigated CEUS perfusion imaging in 102 kidneys of 51 children with unilateral disease. Similar to our study findings, no significant difference in perfusion parameter and their AUC was detected between the diseased and healthy kidneys [ 14 ]. Harrois et al denoted short-term changes in renal blood flow assessed by CEUS [ 15 ].…”

Section: Discussionsupporting

confidence: 91%

Assessment of Renal Transplant Perfusion by Contrast-Enhanced Ultrasound after Switch from Calcineurin Inhibitor to Belatacept: A Pilot Study

Osmanodja

Muench

Holderied

et al. 2022

JCM

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Calcineurin inhibitors (CNIs) have improved short-term kidney allograft survival but are nephrotoxic and vasoconstrictive. Vasoconstriction is potentially reversible after switching from CNIs to belatacept. The kidney allograft shows optimal requirements for dynamic perfusion imaging using contrast-enhanced ultrasound (CEUS). We performed standardized CEUS in patients after switching from CNIs to belatacept for clinical indication to study the suitability of CEUS, in order to assess the effects of CNI cessation on kidney allograft perfusion. Eleven kidney transplant patients were enrolled from February 2020 until November 2020. Demographic, clinical, and laboratory parameters, as well as perfusion imaging, were assessed at baseline and 6 months after switching immunosuppression. Quantification of perfusion imaging on CEUS was performed using a post-processing software tool on uncompressed DICOM cine loops. After CNI cessation, estimated glomerular filtration rate increased by 4.8 mL/min/1.73 m2 (16%). Despite good quality of fit and comparable regions of interest in baseline and follow-up CEUS examinations, quantification of perfusion imaging showed a slightly improved cortical perfusion without reaching statistical significance after CNI cessation. This is the first study that systematically investigates the suitability of CEUS to detect changes of microvascular perfusion in kidney transplant recipients in vivo. No significant differences could be detected in perfusion measurements before and after CNI cessation.

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Section: Discussionsupporting

confidence: 91%

Assessment of Renal Transplant Perfusion by Contrast-Enhanced Ultrasound after Switch from Calcineurin Inhibitor to Belatacept: A Pilot Study

Osmanodja

Muench

Holderied

et al. 2022

JCM

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show abstract

“…Previously, several pre-clinical and clinical studies testing the application of CEUS in the evaluation of renal microvascular perfusion have shown promising results [ 17 ]. However, to the best of our knowledge, few pediatric patients has been involved in previous studies on the use of CEUS to assess renal microvascular perfusion[ 18 ]. In this study, we aimed to explore the feasibility of CEUS in evaluating renal microvascular perfusion in pediatric patients and to pave the way for its use in clinics.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of contrast-enhanced ultrasonography (CEUS) in evaluating renal microvascular perfusion in pediatric patients

Zhang

Cai

et al. 2022

BMC Med Imaging

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Background Changes in renal microvascular perfusion are involved in several kidney diseases. Contrast-enhanced ultrasonography (CEUS) quantitative analysis can enable the estimation of renal microvascular perfusion non-invasively. However, to date, few pediatric patients with renal disease have been subjected to CEUS quantitative analysis. This study aimed to explore the feasibility of CEUS in evaluating renal microvascular perfusion in pediatric patients and paving its way to clinical practice. Methods Seventeen pediatric patients with chronic kidney disease (CKD) and five children without kidney disease were consecutively examined using CEUS. Quantitative analysis of CEUS images based on time-intensity curve (TIC) fittings was performed using specialized software. Quantitative parameters of wash-in microvascular blood flow, including A, k, B, and TtoPk, were generated from three regions of interest (ROIs) each in the cortex and medulla of each kidney. Results CEUS was performed in all children successfully and safely without the use of sedatives. All parameters (A, B, k, and TtoPk) demonstrated no statistical differences among the three sampling ROIs in the renal cortex and medulla. All parameters (A, B, k, and TtoPk) showed no statistical differences between the left and right sides of kidneys both in cortices and medullas. Comparing with patients with CKD stage 3–5, both control group and patients with CKD stage 1–2 had significantly higher values of parameter A in the renal cortex (p = 0.025 and p = 0.031, respectively). In control group and patients stage 1–2, the values of parameters k in the renal cortices were significantly higher than that in the renal medullas, while in patients with CKD stage 3–5, parameter k showed no statistically significant differences between the renal cortex and medulla (p = 0.173). Conclusion CEUS is safe and practicable in pediatric patients with chronic kidney disease. Renal microvascular perfusion estimated by CEUS could be a robust approach in the evaluation of pediatric renal diseases. Parameters A and k derived from CEUS quantitative analysis can provide great potential in non-invasive assessment of renal microvascular perfusion impairment in pediatric CKD.

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Standardized evaluation methodology for renal cortical blood perfusion in elderly patients using contrast‐enhanced ultrasound: A Chinese expert consensus (2024 edition)

Junhong,

Wen

2024

Aging Medicine

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As a sensitive and non‐invasive method for assessing changes in renal cortical blood perfusion in the elderly, contrast‐enhanced ultrasound (CEUS) can indirectly reflect changes in kidney filtration and reabsorption function, thus providing feasibility for early evaluation of renal function changes. However, significant differences exist among researchers in terms of operational methods, contrast agent selection, post‐data analysis, and many other aspects, leading to substantial heterogeneity in results. This hinders horizontal comparisons and greatly limits the clinical application of contrast‐enhanced ultrasound for evaluating renal cortical blood flow perfusion. Based on the latest domestic and overseas literature and discussions with clinical experts, this consensus provides recommended guidelines for the evaluation of renal cortical blood flow perfusion using contrast‐enhanced ultrasound. It is hoped that this consensus will promote a better understanding of CEUS among medical practitioners at all levels and standardize the examination of renal cortical blood flow perfusion with CEUS.

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Quantitative assessment of renal perfusion in children with UPJO by contrast enhanced ultrasound: A pilot study

Cited by 4 publications

References 19 publications

Assessment of Renal Transplant Perfusion by Contrast-Enhanced Ultrasound after Switch from Calcineurin Inhibitor to Belatacept: A Pilot Study

Assessment of Renal Transplant Perfusion by Contrast-Enhanced Ultrasound after Switch from Calcineurin Inhibitor to Belatacept: A Pilot Study

Feasibility of contrast-enhanced ultrasonography (CEUS) in evaluating renal microvascular perfusion in pediatric patients

Standardized evaluation methodology for renal cortical blood perfusion in elderly patients using contrast‐enhanced ultrasound: A Chinese expert consensus (2024 edition)

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