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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Usefulness of Contrast-enhanced Ultrasound in the Evaluation of Chronic Kidney Disease

Author(s): Byoung Hee Han and Sung Bin Park*

Volume 17, Issue 8, 2021

Published on: 27 January, 2021

Page: [1003 - 1009] Pages: 7

DOI: 10.2174/1573405617666210127101926

Abstract

Background: Contrast-enhanced ultrasound (CEUS) can provide more improved images of renal blood flow and much more information of both macro- and microcirculation of the kidney as compared to Doppler US.

Objective: To investigate the usefulness of CEUS by analyzing differences in perfusion-related parameters among the three chronic kidney disease (CKD) subgroups and the control group.

Methods: Thirty-eight patients with CKD and 21 controls who were age-matched (20−49 years) were included. Included CKD patients were stratified into three groups according to their eGFR: group I, eGFR ≥ 60 ml/min/1.73 m2 (GFR category I and II); group II, 30 ml/min/1.73 m2 ≤ eGFR < 60 ml/min/1.73 m2 (GFR category III); and group III, eGFR < 30 ml/min/1.73 m2 (GFR category IV and V). Comparisons with the controls (eGFR > 90 ml/min/1.73 m2) were performed. Real-time and dynamic renal cortex imaging was performed using CEUS. Time-intensity curves and several bolus model quantitative perfusion parameters were created using the VueBox® quantification software. We compared the parameters among the CKD subgroups and between the CKD and control groups.

Results: Eight patients were included in group I, 12 patients in group II, and 18 patients in group III. Significant differences were noted in the wash-in and wash-out rates between the CKD and control groups (p = 0.027 and p = 0.018, respectively), but not between those of the CKD subgroups. There were no significant differences of other perfusion parameters among the CKD subgroups and between the CKD and control groups.

Conclusion: A few perfusion related CEUS parameters (WiR and WoR) can be used as markers of renal microvascular perfusion relating renal function. CEUS can effectively and quantitatively exhibit the renal microvascular perfusion in patients with CKD as well as normal control participants.

Keywords: Contrast-enhanced ultrasound, chronic kidney disease, renal impairment, perfusion, microcirculation, quantitative evaluation.

Graphical Abstract
[1]
Remer EM, Papanicolaou N, Casalino DD, et al. ACR Appropriateness Criteria(®) on renal failure. Am J Med 2014; 127(11): 1041-8. e1.
[http://dx.doi.org/10.1016/j.amjmed.2014.05.014] [PMID: 24865874]
[2]
Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 2014; 63(5): 713-35.
[http://dx.doi.org/10.1053/j.ajkd.2014.01.416] [PMID: 24647050]
[3]
Herget-Rosenthal S. Imaging techniques in the management of chronic kidney disease: current developments and future perspectives. Semin Nephrol 2011; 31(3): 283-90.
[http://dx.doi.org/10.1016/j.semnephrol.2011.05.011] [PMID: 21784277]
[4]
Daghini E, Primak AN, Chade AR, et al. Assessment of renal hemodynamics and function in pigs with 64-section multidetector CT: comparison with electron-beam CT. Radiology 2007; 243(2): 405-12.
[http://dx.doi.org/10.1148/radiol.2432060655] [PMID: 17456868]
[5]
Zhou HY, Chen TW, Zhang XM. Functional magnetic resonance imaging in acute kidney injury: Present status. BioMed Res Int 2016; 2016: 2027370.
[http://dx.doi.org/10.1155/2016/2027370] [PMID: 26925411]
[6]
Cosgrove D, Lassau N. Imaging of perfusion using ultrasound. Eur J Nucl Med Mol Imaging 2010; 37(Suppl. 1): S65-85.
[http://dx.doi.org/10.1007/s00259-010-1537-7] [PMID: 20640418]
[7]
Denham SL, Alexander LF, Robbin ML. Contrast-enhanced ultrasound: practical review for the assessment of hepatic and renal lesions. Ultrasound Q 2016; 32(2): 116-25.
[http://dx.doi.org/10.1097/RUQ.0000000000000182] [PMID: 27233070]
[8]
Prakash A, Tan GJ, Wansaicheong GK. Contrast enhanced ultrasound of kidneys. Pictorial essay. Med Ultrason 2011; 13(2): 150-6.
[PMID: 21655542]
[9]
McArthur C, Baxter GM. Current and potential renal applications of contrast-enhanced ultrasound. Clin Radiol 2012; 67(9): 909-22.
[http://dx.doi.org/10.1016/j.crad.2012.01.017] [PMID: 22464920]
[10]
Setola SV, Catalano O, Sandomenico F, Siani A. Contrast-enhanced sonography of the kidney. Abdom Imaging 2007; 32(1): 21-8.
[http://dx.doi.org/10.1007/s00261-006-9001-7] [PMID: 17420958]
[11]
Nilsson A. Contrast-enhanced ultrasound of the kidneys. Eur Radiol 2004; 14(Suppl. 8): 104-9.
[http://dx.doi.org/10.1007/s10406-004-0083-4] [PMID: 15700338]
[12]
Bertolotto M, Martegani A, Aiani L, Zappetti R, Cernic S, Cova MA. Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced CT. A feasibility study. Eur Radiol 2008; 18(2): 376-83.
[http://dx.doi.org/10.1007/s00330-007-0747-2] [PMID: 17851664]
[13]
Ascenti G, Mazziotti S, Zimbaro G, et al. Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 2007; 243(1): 158-65.
[http://dx.doi.org/10.1148/radiol.2431051924] [PMID: 17392251]
[14]
Fischer K, Meral FC, Zhang Y, et al. High-resolution renal perfusion mapping using contrast-enhanced ultrasonography in ischemia-reperfusion injury monitors changes in renal microperfusion. Kidney Int 2016; 89(6): 1388-98.
[http://dx.doi.org/10.1016/j.kint.2016.02.004] [PMID: 27165821]
[15]
Kleinert S, Roll P, Baumgaertner C, et al. Renal perfusion in scleroderma patients assessed by microbubble-based contrast-enhanced ultrasound. Open Rheumatol J 2012; 6: 50-3.
[http://dx.doi.org/10.2174/1874312901206010050] [PMID: 22670165]
[16]
Kogan P, Johnson KA, Feingold S, et al. Validation of dynamic contrast-enhanced ultrasound in rodent kidneys as an absolute quantitative method for measuring blood perfusion. Ultrasound Med Biol 2011; 37(6): 900-8.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2011.03.011] [PMID: 21601135]
[17]
Ma F, Cang Y, Zhao B, et al. Contrast-enhanced ultrasound with SonoVue could accurately assess the renal microvascular perfusion in diabetic kidney damage. Nephrol Dial Transplant 2012; 27(7): 2891-8.
[http://dx.doi.org/10.1093/ndt/gfr789] [PMID: 22532616]
[18]
Tsuruoka K, Yasuda T, Koitabashi K, et al. Evaluation of renal microcirculation by contrast-enhanced ultrasound with Sonazoid as a contrast agent. Int Heart J 2010; 51(3): 176-82.
[http://dx.doi.org/10.1536/ihj.51.176] [PMID: 20558907]
[19]
Schneider AG, Hofmann L, Wuerzner G, et al. Renal perfusion evaluation with contrast-enhanced ultrasonography. Nephrol Dial Transplant 2012; 27(2): 674-81.
[http://dx.doi.org/10.1093/ndt/gfr345] [PMID: 21690200]
[20]
Schneider AG, Goodwin MD, Schelleman A, Bailey M, Johnson L, Bellomo R. Contrast-enhanced ultrasonography to evaluate changes in renal cortical microcirculation induced by noradrenaline: a pilot study. Crit Care 2014; 18(6): 653.
[http://dx.doi.org/10.1186/s13054-014-0653-3] [PMID: 25439317]
[21]
Jeong S, Park SB, Kim SH, Hwang JH, Shin J. Clinical significance of contrast-enhanced ultrasound in chronic kidney disease: a pilot study. J Ultrasound 2019; 22(4): 453-60.
[http://dx.doi.org/10.1007/s40477-019-00409-x] [PMID: 31606854]
[22]
Bonventre JV, Yang L. Cellular pathophysiology of ischemic acute kidney injury. J Clin Invest 2011; 121(11): 4210-21.
[http://dx.doi.org/10.1172/JCI45161] [PMID: 22045571]
[23]
Le Dorze M, Legrand M, Payen D, Ince C. The role of the microcirculation in acute kidney injury. Curr Opin Crit Care 2009; 15(6): 503-8.
[http://dx.doi.org/10.1097/MCC.0b013e328332f6cf] [PMID: 19829106]
[24]
Wang L, Xia P, Lv K, et al. Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease. Eur Radiol 2014; 24(7): 1694-9.
[http://dx.doi.org/10.1007/s00330-014-3162-5] [PMID: 24744199]
[25]
Levey AS, Cattran D, Friedman A, et al. Proteinuria as a surrogate outcome in CKD: report of a scientific workshop sponsored by the National Kidney Foundation and the US Food and Drug Administration. Am J Kidney Dis 2009; 54(2): 205-26.
[http://dx.doi.org/10.1053/j.ajkd.2009.04.029] [PMID: 19577347]
[26]
Bosmans JL, Ysebaert DK, Verpooten GA. Chronic allograft nephropathy: what have we learned from protocol biopsies? Transplantation 2008; 85(7)(Suppl.): S38-41.
[http://dx.doi.org/10.1097/TP.0b013e318169c5d0] [PMID: 18401262]
[27]
Girometti R, Stocca T, Serena E, Granata A, Bertolotto M. Impact of contrast-enhanced ultrasound in patients with renal function impairment. World J Radiol 2017; 9(1): 10-6.
[http://dx.doi.org/10.4329/wjr.v9.i1.10] [PMID: 28144402]
[28]
Cantisani V, Wilson SR Sr. CEUS: Where are we in 2015? Eur J Radiol 2015; 84(9): 1621-2.
[http://dx.doi.org/10.1016/j.ejrad.2015.05.028] [PMID: 26093473]
[29]
Kim JK, Hong SS, Choi YJ, et al. Wash-in rate on the basis of dynamic contrast-enhanced MRI: usefulness for prostate cancer detection and localization. J Magn Reson Imaging 2005; 22(5): 639-46.
[http://dx.doi.org/10.1002/jmri.20431] [PMID: 16200542]

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