Nephron Clinical Practice

Original Paper

Color Doppler Ultrasound in Renal Transplant: Role of Resistive Index versus Renal Cortical Ratio in the Evaluation of Renal Transplant Diseases

Drudi F.M.a · Pretagostini R.b · Padula S.a · Donnetti M.c · Giovagnorio F.a · Mendicino P.a · Marchetti F.a · Ricci P.a · Passariello R.a

Author affiliations

Departments of aRadiology, bTransplant Surgery, and cMedical Physics, Experimental Medicine and Pathology, University ‘La Sapienza’, Policlinico Umberto I, Rome, Italy

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Nephron Clin Pract 2004;98:c67–c72

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 28, 2003
Accepted: May 11, 2004
Published online: November 17, 2004
Issue release date: November 2004

Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 5


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC

Abstract

Background/Aims: Ultrasound (US) and color Doppler are not sensitive enough to detect anomalies in cortical perfusion, which is affected in most graft dysfunctions. The renal cortical ratio (RCR) is a variation in the resistive index (RI) values from the renal artery to cortical vessels, expressed in percent. The aim of this study was to compare the RI and RCR in the differentiation of normal and pathological grafts, to assess the positive predictive value of RCR and show that RCR enables earlier diagnosis than RI. Methods: Based on clinical, biochemical and histological examinations, 494 renal allografts were divided into 3 groups (normal grafts, acute and chronic pathologies). All patients underwent US color Doppler. RI was measured and RCR calculated. Follow-up confirmed the initial division in groups. Statistical significance was calculated using the two-tailed Student’s t test. The positive predictive value was calculated for each group. Results: 24 h after transplant, RCR differentiated normal grafts from acute dysfunctions despite confusing biochemical values and clinical symptoms. In chronic patients, RCR variations occurred later but always before the serum creatinine level increased. Conclusion: RCR presented a higher positive predictive value than RI. RCR curves were already altered in the early stages of transplant pathologies. RCR calculation is easy and makes a significant contribution towards a correct early diagnosis.

© 2004 S. Karger AG, Basel




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References

  1. Trillaud H, Merville P, Le Linh PT, et al: Color Doppler sonography in early renal transplantation follow-up: RI measurements versus power Doppler sonography. Am J Roentgenol 1998;171:1611–1615.
  2. Haas M, Kraus ES, Samaniego-Picota M, et al: Acute renal allograft rejection with intimal arteritis: Histologic predictors of response to therapy and graft survival. Kidney Int 2002;61:1516–1526.
  3. Hollenbeck M, Hilbert N, Meusel F, Grabensee B: Increasing sensitivity and specificity of Doppler sonographic detection of renal transplant rejection with serial investigation technique. Clin Invest 1994;72:609–615.
  4. Allen KS, Jorkasky DK, Arger PH, et al: Renal allografts: Prospective analysis of Doppler sonography. Radiology 1988;169:371–376.
  5. Krumme B, Grotz W, Kirste G, et al: Determinants of intrarenal Doppler indices in stable renal allografts. J Am Soc Nephrol 1997;8:813–816.
  6. Quarto di Palo F, Rivolta R, Elli A, Castagnone D: Relevance of resistive index ultrasonographic measurement in renal transplantation. Nephron 1996;73:195–200.
  7. Platt JF, Rubin J, Ellis JH: Diabetic nephropathy: Evaluation with renal duplex Doppler US. Radiology 1994;190:343–346.
  8. Baxter G M: Ultrasound of renal transplantation. Clin Radiol 2001;56:802–818.
  9. Rifkin MD, Needlemann L, Pasto ME, et al: Evaluation of renal transplant rejection by duplex Doppler examination: Value of resistive index. Am J Roentgenol 1987;148:759–762.
  10. Wan SKH, Ferguson CJ, Cochlin DL: Duplex Doppler ultrasound in the diagnosis of acute renal allograft rejection. Clin Radiol 1989;40:573–576.
  11. Kelcz F, Pozniak MA, Pirsch JD, Oberly TD: Pyramidal appearance and resistive index: Insensitive and nonspecific sonographic indicators of renal transplant rejection. Am J Roentgenol 1990;155:531–535.
  12. Mobb GE, Veitch PS, Bell PRF: Are serum creatinine levels adequate to identify the onset of chronic cyclosporine A nephrotoxicity? Transplant Proc 1990;22:1708–1710.
  13. Levey AS, Madaio AP, Perrone RD: Laboratory assessment of renal disease; in Brenner BM, Rector FC (eds): The Kidney, ed 4. Philadelphia, Saunders, 1991, pp 919–968.
  14. Brown ED, Chen MYM, Wolfman NT, et al: Complications of renal transplantation: Evaluation with US and radionuclide imaging. Radiographics 2000;20:607–622.
  15. Frauchiger B, Bock A, Eichlisberger R, et al: The value of different resistance parameters in distinguishing biopsy-proved dysfunction of renal allografts. Nephrol Dial Transplant 1995;10:527–532.
  16. Matthew TH: Recurrent disease after transplantation. Transplant Rev 1991;5:233–237.
    External Resources
  17. Racusen LC, Solez K, Colvin RB, et al: The Banff 97 working classification of renal allograft pathology. Kidney Int 1999;55:713–723.
  18. Solez K, Axelsen RA, Benediktsson H, et al: International standardization of criteria for histologic diagnosis of renal allograft rejection: The Banff working classification of kidney transplant pathology. Kidney Int 1993;44:411–422.
  19. Martinoli C, Bertolotto M, Crespi G, et al: Duplex Doppler analysis of interlobular arteries in transplanted kidneys. Eur Radiol 1998;8:765–769.
  20. Quarto di Palo F, Rivolta R, Elli A, Castagnone D: The well-functioning renal graft evaluated by color Doppler flowmetry. Nephron 1995;70:314–318.
  21. Elli A, Quarto di Palo F, Rivolta R et al: Effect of increased arterial resistance index on long-term outcome of well-functioning kidney grafts. Transplant Int 2000;13:S84–S89.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 28, 2003
Accepted: May 11, 2004
Published online: November 17, 2004
Issue release date: November 2004

Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 5


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC


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