Abstract
Gray scale ultrasound has an important diagnostic role in native kidney disease. Low cost, absence of ionizing radiation and nephrotoxicity, short performance time, and repeatability even at the bedside, are the major advantages of this technique. The introduction of contrast enhancement ultrasound (CEUS) in daily clinical practice has significantly reduced the use of contrast enhancement computed tomography (CECT) and contrast enhancement magnetic resonance (CEMR), especially in patients with renal disease. Although there are many situations in which CECT and CEMRI are primarily indicated, their use may be limited by the administration of the contrast medium, which may involve a risk of renal function impairment, especially in the elderly, and in patients with acute kidney injury (AKI) and moderate to severe chronic kidney disease (CKD). In these cases, CEUS can be a valid diagnostic choice. To date, numerous publications have highlighted the role of CEUS in the study of parenchymal micro-vascularization and renal pathology by full integration with second level imaging methods (CECT and CEMRI) both in patients with normal renal function and with diseased kidneys. The aim of this review is to offer an updated overview of the limitations and potential applications of CEUS in native kidney disease.
Highlights
The first guidelines on contrast-enhanced ultrasound (CEUS) date back to 2004 [1]and focused on hepatic disease, whereas non-hepatic applications were taken into account in 2008 [2]
To perform a contrast enhancement ultrasound (CEUS) examination, it is necessary to have an ultrasound system equipped with microbubble-specific technology, capable of separating the signal coming from mi
To perform a CEUS examination, it is necessary to have an ultrasound system equipped with microbubble‐specific technology, capable of separating the signal coming from microbubbles from that of the stationary tissues [11]
Summary
The first guidelines on contrast-enhanced ultrasound (CEUS) date back to 2004 [1]. and focused on hepatic disease, whereas non-hepatic applications were taken into account in 2008 [2]. The first guidelines on contrast-enhanced ultrasound (CEUS) date back to 2004 [1]. The dramatic increase in non-hepatic applications for CEUS made it necessary to release dedicated guidelines in 2011 [3,4]. It is known that the use of B-mode and Doppler ultrasound alone represents a limitation in the study of kidney diseases, while the addition of contrast medium allows the display of vascular abnormalities unappreciated with conventional modes. CEUS of the kidney is off-label in Europe, but widely used for its effectiveness and safety, and recommended by European guidelines [3,4]. The purpose of this review is to offer an updated overview of potential applications and limitations of CEUS in native kidney disease
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