Renal transplant sonography: Correlation of Doppler and biopsy results in cellular rejection

Renowden, S.A.; Griffiths, David; Nair, Sanjeev; Krishnan, Hari B.; Cochlin, D.Ll.

doi:10.1016/s0009-9260(05)80168-0

Cited by 15 publications

(7 citation statements)

References 28 publications

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“…generally provides an indication of disease presence but does not show significant differences among diseases and therefore does not allow a differential diagnosis [24]. A higher-than-normal RI is a sensitive but nonspecific sign of graft disease [25][26][27][28] so that biopsy is often the only means of achieving a diagnosis [29][30][31], even if it involves risks (haematuria, haematoma, arteriovenous fistula, abscess, etc. ).…”

Section: Fig 1 Rene Senza Complicanze: Il Power Doppler Con Mezzo DImentioning

confidence: 99%

“…ma non dimostra significative variazioni tra le suddette e quindi non ne permette la diagnosi differenziale [24]. Infatti, l'indice di resistenza superiore ai valori normali è un segno sensibile ma non specifico dello stato di malattia del rene trapiantato [25][26][27][28] per cui il ricorso alla biopsia è spesso l'unico mezzo per ottenere la diagnosi [29][30][31] This new method offers many advantages over other imaging modalities: absence of ionising radiation, absence of side effects of intravenous contrast administration and complications of biopsy, reduced cost, repeatability over time and, above all, high levels of sensitivity and specificity.…”

Section: Fig 1 Rene Senza Complicanze: Il Power Doppler Con Mezzo DIunclassified

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Functional study of the transplanted kidney with power Doppler US and time/intensity curves

et al. 2007

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Section: Fig 1 Rene Senza Complicanze: Il Power Doppler Con Mezzo DImentioning

confidence: 99%

Section: Fig 1 Rene Senza Complicanze: Il Power Doppler Con Mezzo DIunclassified

Functional study of the transplanted kidney with power Doppler US and time/intensity curves

et al. 2007

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“…Many reports deal with its diagnostic usefulness in renal disease [6][7][8], The opinion receiving most support considers Rl as an index of renal function [9] because its variations are statistically related to levels of plasma cre atinine or to reduction in glomerular filtration rate [10, …”

Section: Introductionmentioning

confidence: 99%

Relevance of Resistive Index Ultrasonographic Measurement in Renal Transplantation

Palo

Rivolta²,

Elli³

et al. 1996

Nephron

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The usefulness of the ultrasonographic measurement of resistive index (RI) is not yet fully understood. To obtain a better definition of its relevance in renal disease we studied this parameter in a group of 212 renal transplant patients, aged between 15 and 55 years: 81 first grafts with an excellent renal function, 44 hypertensive patients, 30 type II diabetics, 29 cases of chronic graft dysfunction, 28 cases during an episode of acute rejection. RI was measured in three different renal vascular areas: prerenal, interlobar and cortical. A two-way analysis of variance showed a statistical significance for the site of RI sampling and the type of pathology. There was no interaction between the two variables studied (p = 0.30). Plasma creatinine levels, analyzed as covariate, showed a high statistical correlation with RI values (p = 0.0001). The mean RI of the 80 transplanted patients with normal creatinine plasma levels showed a remarkable homogeneity and a statistically significant progressive reduction of the values from the main renal artery to the interlobar and cortical vessels (p = 0.00001). In the other groups a greater dispersion of data was present. RI values significantly increased in hypertensive and diabetic patients (p = 0.05) but more in acute rejection (p = 0.0001) or chronic graft dysfunction (p = 0.01). In acute rejection and in chronic graft dysfunction the curve of RI values tended to become flat, while in hypertensive and diabetic patients the aspect of the curve became steeper. In conclusion, RI is a hemodynamic index that reflects the vascular status of the explored area and is not only the simple expression of reduction of the kidney functional units. The differences observed in the various kidney areas stress the importance of measuring this parameter at more than one vascular site. The increase in RI values on the kidney cortex vessels is likely to be an index of glomemlar hyperfiltration. If this hypothesis is true the measure of RI might be a reliable method for diagnosing in the kidney vascular damage, glomemlar hypertension and hypertrophy.

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“…Unfortunately the diagnostic approach used till now was not uniform [13,14] and the published reports were often not concordant [15][16][17][18], Many technical factors explain these results. The vascular area explored is fre quently different (main renal artery, interlobar or arcuate arteries), the sensitivity of the various models of scanner changes, the operator's experience and skill are cnicial and the number and quality of the patients examined are often not comparable.…”

Section: Introductionmentioning

confidence: 99%

The Well-Functioning Renal Graft Evaluated by Color Doppler Flowmetry

Palo

Rivolta²,

Elli³

et al. 1995

Nephron

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The value of color Doppler ultrasound in the renal transplant follow-up has been evaluated. To do so we used a standardized protocol of analysis on a group of 86 outpatients with different transplant ages and a good and stable graft function defined as a plasma creatinine level < 105 µM/l. Renal volume increased after transplantation and averaged 198 ± 54 cm³. The graft volume was positively related to the transplant age (p = 0.04). Mean renal blood flow/ 1.73 m² body surface area was 301 ± 98 ml/min, a value at the lower limit of normality. A statistical inverse relationship between renal blood flow and transplant age was found (p = 0.04). Renal vascular resistances increased along with the transplant age (p = 0.003). Renal function evaluated by creatinine plasma levels and creatinine clearance values did not show any statistical correlation with color Doppler findings in normal grafts. In conclusion, ultrasound measures allow us to obtain more sensitive information about the graft status and might be used for a better evaluation of the transplant follow-up.

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Renal transplant sonography: Correlation of Doppler and biopsy results in cellular rejection

Cited by 15 publications

References 28 publications

Functional study of the transplanted kidney with power Doppler US and time/intensity curves

Functional study of the transplanted kidney with power Doppler US and time/intensity curves

Relevance of Resistive Index Ultrasonographic Measurement in Renal Transplantation

The Well-Functioning Renal Graft Evaluated by Color Doppler Flowmetry

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