Ultrasound contrast agents in the study of kidney function in health and disease

Kalantarinia, Kambiz; Okusa, Mark D.

doi:10.1016/j.ddmec.2007.10.006

Cited by 31 publications

(32 citation statements)

References 53 publications

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“…The two main contrasts used are Levovist® (Schering) and SonoVue® (Bracco). Compared to iodinated contrasts used in CT, their main advantages are that they do not diffuse out of circulation and that they avoid nephrotoxicity, so they can be used safely even in patients with CRF [5]. The only contraindication is severe respiratory failure.…”

Section: Introductionmentioning

confidence: 97%

Contrast-Enhanced Ultrasound (CEUS): an Excellent Tool in the Follow-up of Small Renal Masses Treated with Cryoablation

et al. 2014

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Strict imaging follow-up is mandatory after cryoablation of small renal masses (SRMs). Although it uses ionizing radiation and nephrotoxic iodinated contrast, computed tomography (CT) is still the gold standard test. Contrast-enhanced ultrasound (CEUS) is a novel technique that informs in real time about renal perfusion avoiding radiation and nephrotoxicity. The objective of this study is to compare outcomes between CEUS and CT in the follow-up of SRMs treated with cryoablation, as well as to assess degree of agreement between them. This is a prospective observational study (May 2012 to December 2013) comparing CEUS and CT in 16 patients with SRMs cryoablated. The on-going protocol of the study includes a CT and CEUS 3 months after treatment and then every 6 months during 5 years. Local relapse was defined as the presence of contrast enhancement in the mass. All the CEUS were performed by a single experienced observer (E.S.). Degree of agreement was measured with kappa index. CEUS detected contrast enhancement in three patients (3/16, 18.8%) and CT in two patients (2/16, 12.5%). Degree of agreement between CEUS and CT, according to Landis-Koch classification, was 0.76 (CI 0.33-1.19; p = 0.0165), which is excellent and higher than expected by random. Sensitivity of the test is 93.75% (15/16). Median time of follow-up after cryoablation is 22 months (15.5-36.5). CEUS has an excellent agreement with CT and a high sensitivity in the follow-up of SRMs treated with cryosurgery, demonstrating its usefulness. Due to these encouraging results, it could become a reference test in the near future for monitoring SRMs after ablative treatment.

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Section: Introductionmentioning

confidence: 97%

Contrast-Enhanced Ultrasound (CEUS): an Excellent Tool in the Follow-up of Small Renal Masses Treated with Cryoablation

et al. 2014

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“…Inspired by successes in imaging the liver, efforts have been made by several researchers to test the utility of this technique in the evaluation of the kidney [3, 4]. In addition to the value of the method for imaging focal lesions [5], great interest has been focused on the assessment of renal blood perfusion [6].…”

Section: Introductionmentioning

confidence: 99%

Time-intensity curve analysis of contrast-enhanced ultrasound is unable to differentiate renal dysfunction in the early post-transplant period - a prospective study

Araújo

Suassuna

2018

BMC Nephrol

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BackgroundContrast enhanced ultrasonography (CEUS) assessment of kidney allografts mainly focuses on graft rejection. However, studies on delayed graft function (DGF) without acute rejection are still lacking. The aim of this study was to build a time-intensity curve (TIC) using CEUS in non-immunological DGF to understand the utility of CEUS in early transplantation.MethodsTwenty-eight patients in the short-term postoperative period (<14 days) were divided according to the need for dialysis (early graft function [EGF] and [DGF]) and 37 subjects with longer than 90 days follow-up were divided into creatinine tertiles. Time to peak [TTP] and rising time [RT were compared between groups.ResultsEGF and DGF were similar, except for creatinine. In comparison to the late group, medullary TTP and RT were shorter in the early group as well as the delay regarding contrast arrival in the medulla (in relation to cortex) and reaching the medullary peak (in relation to artery and cortex). In the late group, patients with renal dysfunction showed shorter temporal difference to reach medullary peak in relation to artery and cortex.ConclusionsAlthough it was not possible to differentiate EGF and DGF using TIC, differences between early and late groups point to blood shunting in renal dysfunction.

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“…New techniques, such as contrast-enhanced ultrasonography, which enables the quantification of renal tissue perfusion, could be of distinct value in future trials. Bedside assessment of regional renal blood flow early in the course of AKI could be a valuable diagnostic and prognostic tool, 63 although validation studies in patients in the ICU to determine if this technique can facilitate the early diagnosis of AKI and guide the use of therapeutic interventions that target microcirculatory perfusion have yet to be performed.…”

Section: Study Design Considerations and Challenges For Clinical Triamentioning

confidence: 99%

Inflammation in AKI

Rabb

Griffin

McKay

et al. 2016

Journal of the American Society of Nephrology

452

343

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Inflammation is a complex biologic response that is essential for eliminating microbial pathogens and repairing tissue after injury. AKI associates with intrarenal and systemic inflammation; thus, improved understanding of the cellular and molecular mechanisms underlying the inflammatory response has high potential for identifying effective therapies to prevent or ameliorate AKI. In the past decade, much knowledge has been generated about the fundamental mechanisms of inflammation. Experimental work in small animal models has revealed many details of the inflammatory response that occurs within the kidney after typical causes of AKI, including insights into the molecular signals released by dying cells, the role of pattern recognition receptors, the diverse subtypes of resident and recruited immune cells, and the phased transition from destructive to reparative inflammation. Although this expansion of the basic knowledge base has increased the number of mechanistically relevant targets of intervention, progress in developing therapies that improve AKI outcomes by modulation of inflammation remains slow. In this article, we summarize the most important recent developments in understanding the inflammatory mechanisms of AKI, highlight key limitations of the commonly used animal models and clinical trial designs that may prevent successful clinical application, and suggest priority approaches for research toward clinical translation in this area.

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Ultrasound contrast agents in the study of kidney function in health and disease

Cited by 31 publications

References 53 publications

Contrast-Enhanced Ultrasound (CEUS): an Excellent Tool in the Follow-up of Small Renal Masses Treated with Cryoablation

Contrast-Enhanced Ultrasound (CEUS): an Excellent Tool in the Follow-up of Small Renal Masses Treated with Cryoablation

Time-intensity curve analysis of contrast-enhanced ultrasound is unable to differentiate renal dysfunction in the early post-transplant period - a prospective study

Inflammation in AKI

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