The Value of Contrast-Enhanced Ultrasound versus Doppler Ultrasound in Grading Renal Artery Stenosis

Cui, Yanhua; Zhang, Quanbin; Yan, Jiping; Wu, Ji

doi:10.1155/2020/7145728

Cited by 11 publications

(35 citation statements)

References 36 publications

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“…Authors, in a study including 120 patients with 38 stenosed renal arteries, reported surprisingly good results [38]; sensitivity, specificity, PPV, NPV and accuracy were reported as being 100%, 84%, 0%, 80% and 94%, respectively, for CDUS compared with angiography. Recently, Cui et al [39] have shown that CEUS is accurate in grading renal artery stenosis, and may represent the method of choice in diagnosing renal artery stenosis. Nevertheless, the use of CEUS in patients with renal artery stenosis is still debated and, in the near future, the application of new parametric software will allow for a quantitative analysis of contrast enhancement curves and a more accurate definition of renal perfusion.…”

Section: Renal Artery Stenosismentioning

confidence: 99%

Role of Contrast-Enhanced Ultrasound (CEUS) in Native Kidney Pathology: Limits and Fields of Action

Granata

Campo²,

Lentini

et al. 2021

Diagnostics

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Gray scale ultrasound has an important diagnostic role in native kidney disease. Low cost, absence of ionizing radiation and nephrotoxicity, short performance time, and repeatability even at the bedside, are the major advantages of this technique. The introduction of contrast enhancement ultrasound (CEUS) in daily clinical practice has significantly reduced the use of contrast enhancement computed tomography (CECT) and contrast enhancement magnetic resonance (CEMR), especially in patients with renal disease. Although there are many situations in which CECT and CEMRI are primarily indicated, their use may be limited by the administration of the contrast medium, which may involve a risk of renal function impairment, especially in the elderly, and in patients with acute kidney injury (AKI) and moderate to severe chronic kidney disease (CKD). In these cases, CEUS can be a valid diagnostic choice. To date, numerous publications have highlighted the role of CEUS in the study of parenchymal micro-vascularization and renal pathology by full integration with second level imaging methods (CECT and CEMRI) both in patients with normal renal function and with diseased kidneys. The aim of this review is to offer an updated overview of the limitations and potential applications of CEUS in native kidney disease.

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Section: Renal Artery Stenosismentioning

confidence: 99%

Role of Contrast-Enhanced Ultrasound (CEUS) in Native Kidney Pathology: Limits and Fields of Action

Granata

Campo²,

Lentini

et al. 2021

Diagnostics

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“…Renal cortical blood perfusion was an important imaging index that affected the prognosis of RAS patients. Feng Qichen et al ( 7 ) found that the renal filtration fraction increased significantly before stenting by using 99mTc-EC to measure the effective renal plasma flow, combined with radionuclide renal imaging to determine GFR, and calculate the renal filtration fraction (normally 18–22%). Patients with normal preoperative renal filtration scores had partially improved renal function, while those with a reduced preoperative renal filtration score had a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have confirmed that age, diabetes, and severe hypertension were conventional factors for RFD in RAS patients ( 6 ). In addition, for patients with severe stenosis requiring stenting, the degree of RAS was not significantly related to the risk of RFD ( 7 , 8 ). However, with the progress of contrast-enhanced ultrasound (CEUS) and other imaging omics, renal parenchymal blood perfusion was also an important factor ( 9 ).…”

Section: Introductionmentioning

confidence: 94%

Development and Validation of a Prognostic Nomogram for Prognosis in Patients With Renal Artery Stenosis

Zhang

et al. 2022

Front. Med.

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Background and ObjectiveRenal artery stenosis (RAS) is associated with an increased risk of renal function deterioration (RFD). Our previous study showed that renal cortical blood perfusion assessed by contrast-enhanced ultrasound (CEUS) was an important related factor for RFD in RAS patients. Based on several conventional related factors confirmed by previous studies, we aimed to establish and verify a CEUS+ scoring system to evaluate the risk of RFD at 1 year of follow-up in RAS patients.MethodsThis study was a single-center retrospective study. A total of 497 elderly RAS patients (247 in the training group and 250 in the verification group) admitted to the Beijing Hospital from January 2016 to December 2019 were included. The baseline characteristics of the patients on admission (including general conditions, previous medical history, blood pressure, blood creatinine, RAS, and cortical blood perfusion in the affected kidney) and renal function [glomerular filtration rate (GFR)] at 1-year of follow-up were collected. We used the univariate and multivariate logistic regressions to establish a CEUS+ scoring system model, the receiver operating characteristic (ROC) curve and area under the curve (AUC) to evaluate prediction accuracy, and the decision curve analysis and nomogram to evaluate the clinical application value of CEUS+ scoring system model.ResultsAmong the 497 patients enrolled, 266 (53.5%) were men, with an average age of (51.7 ± 19.3) years. The baseline clinical-radiomic data of the training group and the verification group were similar (all p > 0.05). Multivariate logistic regression analysis results showed that age [Odds ratio (OR) = 1.937, 95% confidence interval (CI): 1.104–3.397), diabetes (OR = 1.402, 95% CI: 1.015–1.938), blood pressure (OR = 1.575, 95% CI: 1.138–2.182), RAS (OR = 1.771, 95% CI: 1.114–2.816), and area under ascending curve (AUCi) (OR = 2.131, 95% CI: 1.263–3.596) were related factors for the renal function deterioration after 1 year of follow-up (all p < 0.05). The AUC of the ROC curve of the CEUS+ scoring system model of the training group was 0.801, and the Youden index was 0.725 (specificity 0.768, sensitivity 0.813); the AUC of the ROC curve of the validation group was 0.853, Youden index was 0.718 (specificity 0.693, sensitivity 0.835). There was no significant difference in ROC curves between the two groups (D = 1.338, p = 0.325). In addition, the calibration charts of the training and verification groups showed that the calibration curve of the CEUS+ scoring system was close to the standard curve (p = 0.701, p = 0.823, both p > 0.10).ConclusionThe CEUS+ scoring system model is helpful in predicting the risk of worsening renal function in elderly RAS patients.

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“…Contrast-enhanced US can be used to directly depict stenosis in the renal artery and poststenotic dilatation [ 23 , 66 ] ( Figure 5 ). In addition, the US signal of an involved kidney is lower than that of the other kidney in the case of unilateral RAS [ 67 ].…”

Section: Renal Artery Us: Imaging Featuresmentioning

confidence: 99%

Gray-Scale, Color Doppler, Spectral Doppler, and Contrast-Enhanced Renal Artery Ultrasound: Imaging Techniques and Features

Park

2022

JCM

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Renal artery stenosis (RAS) is increasingly being detected in elderly patients as life expectancy increases. RAS induces hypertension or reduces renal function. Computed tomography or magnetic resonance angiography are objective in detecting RAS but may cause iodine-induced nephrotoxicity or nephrogenic systemic fibrosis in patients with RAS. Ultrasound (US) is, by contrast, a noninvasive and real-time imaging modality useful in patients with reduced renal function. Renal US is not as sensitive for detecting RAS because this technique indirectly assesses the renal artery by analyzing intrarenal hemodynamic changes. Although, ideally, US would be used to directly evaluate the renal artery, its current utility for RAS detection remains unclear. The purpose of this review is to introduce how to assess renal artery with US, to describe imaging features of renal artery US, to compare renal artery US and renal US, and to show how to perform work-up in patients in whom RAS is suspected.

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The Value of Contrast-Enhanced Ultrasound versus Doppler Ultrasound in Grading Renal Artery Stenosis

Cited by 11 publications

References 36 publications

Role of Contrast-Enhanced Ultrasound (CEUS) in Native Kidney Pathology: Limits and Fields of Action

Role of Contrast-Enhanced Ultrasound (CEUS) in Native Kidney Pathology: Limits and Fields of Action

Development and Validation of a Prognostic Nomogram for Prognosis in Patients With Renal Artery Stenosis

Gray-Scale, Color Doppler, Spectral Doppler, and Contrast-Enhanced Renal Artery Ultrasound: Imaging Techniques and Features

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