Contrast‐Enhanced Ultrasound Examination for the Assessment of Renal Perfusion in Cats with Chronic Kidney Disease

Abstract

BackgroundContrast‐enhanced ultrasound examination (CEUS) is a functional imaging technique allowing noninvasive assessment of tissue perfusion. Studies in humans show that the technique holds great potential to be used in the diagnosis of chronic kidney disease (CKD). However, data in veterinary medicine are currently lacking.ObjectivesTo evaluate renal perfusion using CEUS in cats with CKD.AnimalsFourteen client‐owned cats with CKD and 43 healthy control cats.MethodsProspective case‐controlled clinical trial using CEUS to evaluate renal perfusion in cats with CKD compared to healthy control cats. Time‐intensity curves were created, and perfusion parameters were calculated using off‐line software. A linear mixed model was used to examine differences between perfusion parameters of cats with CKD and healthy cats.ResultsIn cats with CKD, longer time to peak and shorter mean transit times were observed for the renal cortex. In contrast, a shorter time to peak and rise time were seen for the renal medulla. The findings for the renal cortex indicate decreased blood velocity and shorter total duration of enhancement, likely caused by increased vascular resistance in CKD. Increased blood velocity in the renal medulla has not been described before and may be because of a different response to regulatory factors in cortex and medulla.Conclusions and Clinical ImportanceContrast‐enhanced ultrasound examination was capable of detecting perfusion changes in cats with CKD. Further research is warranted to assess the diagnostic capabilities of CEUS in early stage of the disease process.

Renal perfusion parameters measured by contrast‐enhanced ultrasound in healthy dogs demonstrate a wide range of variability in the long‐term

“…Therefore, the blood velocity parameter, time‐to‐peak, may be useful in detecting early changes in renal perfusion related to the development of chronic kidney disease. In human patients with diabetic nephropathy and cats with chronic kidney disease, time‐to‐peak was significantly prolonged compared to healthy individuals . Future studies are warranted to investigate whether time‐to‐peak is a suitable contrast‐enhanced ultrasound parameter for discriminating between healthy and chronic kidney disease dogs.…”

“…The first author performed all analyses after receiving training in contrast‐enhanced ultrasound quantification. The quantification protocol was adapted from previous studies . Based on the high intra‐observer agreement of contrast‐enhanced ultrasound perfusion quantification described by Wei et al., measurements on the video clips were performed once, consecutively.…”

“…In companion animals, contrast‐enhanced ultrasound has shown potential in assessing renal perfusion and renal diseases. In cats, it has detected renal perfusion differences after administration of angiotensin II and in chronic kidney disease patients . It has also been evaluated in dogs with iatrogenic hypercortisolism .…”

Quantitative Assessment of Renal Function In Children with UPJO By Contrast-enhanced Ultrasound ： A Pilot Study

“…It has been shown to be a cost-effective modality for evaluating renal function impairment (RFI) [6]. Studies have shown that contrast-enhanced US is almost as sensitive as radioisotope renography in the quantitative diagnosis of chronic renal insufficiency, and correspondingly, contrast-enhanced US could be a useful tool for the assessment of renal function in children with UPJO [7][8][9]. Ionizing radiation exposure is a known risk factor for patients with leukaemia and brain tumours, especially for children with a higher radiation sensitivity and longer life expectancy [10,11].The European Federation of Societies for Ultrasound in Medicine and Biology( EFSUMB)release guidelines state that intravenous CEUS is safe and effective in paediatric populations and can be used effectively to avoid ionizing radiation exposure [11].…”

Acoustic bubbles in therapy: Recent advances with medical microbubbles, clouds, and harmonic antibubbles

“…Invited speaker Steven Freear from the Universtiy of Leeds spoke about ultrafast plane-wave imaging for nonlinear detection of therapeutic microbubbles [5]. Katrien Vanderperren from Ghent University gave a presentation on contrast-enhanced ultrasound of kidneys in hyperthyroid cats [6]. Erik Verboven from Ghent University presented a study on ultrasound-based dosimetry for radiotherapy, including the in-vitro and in-vivo proof-of-principle.…”