Contribution of color and power Doppler sonography to the differential diagnosis of acute and chronic rejection, and tacrolimus nephrotoxicity in renal allografts |
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Authors: | S Venz Andreas Kahl Johannes Hierholzer Matthias Gutberlet Bettina Windrich Wolf O Bechstein Norbert Hosten Ulrich Frei Roland Felix |
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Institution: | (1) Department of Radiology, Klinik für Strahlenheilkunde, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany, DE;(2) Department of Nephrology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany, DE;(3) Department of Abdominal and Transplant Surgery, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany, DE |
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Abstract: | The aim of the present study was to differentiate acute rejection, chronic rejection, and tacrolimus nephrotoxicity with
color and power Doppler imaging of renal transplants. One hundred examinations were obtained from 45 patients. Pulsatility
and resistive indices were calculated from color Doppler images. The grade of renal vascularization was quantified using computer-assisted
pixel analysis in a rectangular region-of-interest. The percentage of vessel-covered renal parenchyma (POV) was calculated
using a histogram that discriminated renal vessels from renal parenchyma via power Doppler images. Furthermore, the distance
from the most peripherally located vessels to the renal capsule (PVD) was measured. A reduced POV K 55 % proved to be the
best discriminator when chronic rejection was suspected (sensitivity 79 %, specificity 87 %). Tacrolimus nephrotoxicity showed
not only a moderate elevation of the Doppler signal but also an increased PVD L 3.9 mm and a normal POV. We conclude that
the evaluation of renal vessels by power Doppler images improves diagnostic accuracy for patients with renal allografts.
Received: 22 June 1998 Received after revision: 29 September 1998 Accepted: 12 October 1998 |
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Keywords: | Doppler sonography Acute rejection Chronic rejection Tacrolimus Kidney transplantation |
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