Early assessment of chronic kidney dysfunction using contrast-enhanced ultrasound: a pilot study

Br J Radiol. 2014 Oct;87(1042):20140350. doi: 10.1259/bjr.20140350. Epub 2014 Jul 25.

Abstract

Objective: We performed a prospective study to evaluate the value of contrast-enhanced (CE) ultrasound in quantitative evaluation of renal cortex perfusion in patients with chronic kidney dysfunction (CKD Stage I-II).

Methods: The present study was approved by the institutional ethics committee. The study focused on 41 consecutive patients (males, 32; females, 9; mean age, 55.0 ± 5.0 years) with clinical suspicion of CKD (Stages I-II). For both kidneys, CE ultrasound was performed after intravenous bolus injection of 1.0 ml SonoVue® (Bracco Imaging S.p.A., Milan, Italy). Time-intensity curves (TICs) and quantitative indexes were created with Qlab software (Philips, Bothell, WA). 45 healthy volunteers were included as control group. All statistical analyses were performed with SPSS® v. 15.0 software package (SPSS, Chicago, IL). A difference was considered statistically significant with p < 0.05.

Results: Patients with CKD (Stages I-II) had no obvious change in the shape of TICs. Among all quantitative indexes, the changes of area under the curve (AUC), derived peak intensity (DPI) and slope rate of elevation curve (A) were statistically significant (p < 0.05). DPI <12 dB, A >2 and AUC >1300 dB s had high utility in the evaluation of CKD, with 81%, 73% and 78% specificities and 76%, 73% and 77% sensitivities.

Conclusion: CE ultrasound might be valuable in the early evaluation of CKD. AUC, A and DPI might be valuable quantitative indexes.

Advances in knowledge: Quantitative CE ultrasound analysis can be used for the standardized and early evaluation of renal dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Area Under Curve
  • Contrast Media
  • Feasibility Studies
  • Female
  • Humans
  • Image Enhancement / methods*
  • Kidney Cortex / physiopathology*
  • Male
  • Middle Aged
  • Phospholipids
  • Pilot Projects
  • Prospective Studies
  • Regional Blood Flow
  • Renal Insufficiency, Chronic / diagnostic imaging*
  • Renal Insufficiency, Chronic / physiopathology*
  • Sensitivity and Specificity
  • Sulfur Hexafluoride
  • Ultrasonography / methods

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride