Abstract
ObjectivesThe aim of this feasibility study was to prospectively explore in a dog model of chronic ischemic renal disease (CIRD) the hypothesis that real-time contrast-enhanced ultrasonography (CEUS) can quantitatively evaluate the early perfusion changes of renal cortex.Materials and MethodsIn this animal care and use committee-approved study, the model of CIRD was carried out in healthy dogs (10.0∼12.0 kg, n = 5), by placing the Ameroid ring constrictors on the distal portion of right renal artery through operation. CEUS monitoring of right kidney perfusion was performed by intravenous bolus injection of 0.6 ml Sulfur hexafluoride filled microbubbles (SonoVue; Bracco S.P.A., Milan, Italy) every week after operation. The slope rate of ascending curve (A) and descending curve (α), area under curve (AUC), derived peak intensity (DPI), and time to peak (TTP) were measured in renal cortex using commercial quantification software (Q-LAB version 6; Philips Medical Systems, Bothell,WA,USA). The sensitivity of CEUS was compared with blood serum urea nitrogen (BUN) and serum creatinine (SCr) level.ResultsWith the progression of CIRD, dogs showed delayed enhancement and perfusion in renal CEUS curve. Earliest significant changes happened 4 weeks after operation on DPI and TTP which changed from 13.04±2.71 to 15.58±4.75 dB and 9.03±2.01 to 10.62±6.04 sec, respectively (P<.05).ConclusionsCEUS can display the perfusion changes of CIRD in the early period.
Highlights
The rapid technological advances over the past decade have been followed by the introduction of real-time contrast-enhanced ultrasonography (CEUS), which has significantly extended the usefulness of ultrasound imaging in human medicine and medical research
Chronic ischemic renal disease (CIRD) which is very common in clinical medicine is very complicated in its pathological process
We studied the kidney perfusion using CEUS with time-intensity curves (TIC) to measure various perfusion indexes and correlate the results with the pathological findings, in an attempt to identify pathologic patterns in the early stage of CIRD
Summary
The rapid technological advances over the past decade have been followed by the introduction of real-time contrast-enhanced ultrasonography (CEUS), which has significantly extended the usefulness of ultrasound imaging in human medicine and medical research. Ultrasound contrast agents (USCAs) allow the development of new functional applications for renal blood flow quantification [1]. New software tools make it possible to quantitatively evaluate the tissue enhancement and describe important parameters of tissue vitality. Impairment of perfusion is an early event in the course of renal dysfunction and usually precedes functional impairment [2]. The ability to accurately measure variations in renal perfusion could provide important clinical insights into renal function. Various noninvasive imaging methods have been used to evaluate renal dysfunction of CIRD. They are not sensitive in the early stage, and data from different imaging methods are variable, thereby leading to difficulty in diagnosing early renal dysfunction [4,5]
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