A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients

PURPOSEThe present study comparatively evaluates the performance of conventional Doppler ultrasound and superb microvascular imaging (SMI) in delineating the cortical microvessels of the transplanted kidney and compares the chronic allograft damage index (CADI) based on the examination of biopsy spe...

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Main Authors: Ahmet Faruk Gürbüz, Ayşe Keven, Aygül Elmalı, Serap Toru, Ali Apaydın, Kağan Çeken
Format: Article
Language:English
Published: Galenos Publishing House 2023-03-01
Series:Diagnostic and Interventional Radiology
Subjects:
Online Access: http://www.dirjournal.org/archives/archive-detail/article-preview/a-comparison-between-the-superb-microvascular-imag/57233
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author Ahmet Faruk Gürbüz
Ayşe Keven
Aygül Elmalı
Serap Toru
Ali Apaydın
Kağan Çeken
author_facet Ahmet Faruk Gürbüz
Ayşe Keven
Aygül Elmalı
Serap Toru
Ali Apaydın
Kağan Çeken
author_sort Ahmet Faruk Gürbüz
collection DOAJ
description PURPOSEThe present study comparatively evaluates the performance of conventional Doppler ultrasound and superb microvascular imaging (SMI) in delineating the cortical microvessels of the transplanted kidney and compares the chronic allograft damage index (CADI) based on the examination of biopsy specimens with Doppler ultrasound and SMI findings.METHODSSixty-eight renal transplant recipients underwent kidney biopsy with the pre-diagnosis of rejection before undergoing renal Doppler ultrasound examination between January 2020 and October 2020. The distance between the kidney capsule and the vascular structure closest to the kidney capsule was measured at the level of the lower pole in the transplanted kidney using color Doppler ultrasound (CDUS), power Doppler ultrasound (PDUS), and the SMI technique. The kidney size, resistive index at the level of the arcuate artery in the lower pole of the kidney, and renal artery flow rates were also measured.RESULTSThe mean distance between the kidney capsule and the vessel was 2.44 ± 2.0 mm on CDUS, 1.34 ± 1.2 mm on PDUS, 0.99 ± 1.8 mm using the color SMI (cSMI) technique, and 0.86 ± 1.8 mm using the monochrome SMI (mSMI) technique. The study found that the SMI technique was superior to CDUS and PDUS in delineating the cortical microvasculature of the kidney. Both Doppler ultrasound examinations and the SMI technique proved effective in predicting the CADI (P = 0.006 for CDUS, P = 0.002 for PDUS, P = 0.018 for cSMI, and P = 0.027 for mSMI).Among conventional Doppler ultrasound examinations and the SMI technique, PDUS had the highest sensitivity, and cSMI had the highest specificity in differentiating high and low CADI values. Both the cSMI and mSMI techniques had similar sensitivity values, whereas only cSMI exhibited high specificity. CDUS had the lowest specificity value (P = 0.003 for CDUS, P = 0.002 for PDUS, P = 0.005 for cSMI, and P = 0.004 for mSMI).CONCLUSIONThe present study is the first in the literature to demonstrate the utility of the distance between the kidney capsule and the vessels in predicting the CADI score and to compare the Doppler ultrasound examinations and SMI technique in doing so.
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spelling doaj.art-01bf5fcc59bc42d8b8a74e88f3498cfb2023-09-06T11:54:11ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122023-03-0129221221810.5152/dir.2022.2155513049054A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipientsAhmet Faruk Gürbüz0Ayşe Keven1Aygül Elmalı2Serap Toru3Ali Apaydın4Kağan Çeken5 Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey Department of Pathology, Akdeniz University Faculty of Medicine, Antalya, Turkey Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey PURPOSEThe present study comparatively evaluates the performance of conventional Doppler ultrasound and superb microvascular imaging (SMI) in delineating the cortical microvessels of the transplanted kidney and compares the chronic allograft damage index (CADI) based on the examination of biopsy specimens with Doppler ultrasound and SMI findings.METHODSSixty-eight renal transplant recipients underwent kidney biopsy with the pre-diagnosis of rejection before undergoing renal Doppler ultrasound examination between January 2020 and October 2020. The distance between the kidney capsule and the vascular structure closest to the kidney capsule was measured at the level of the lower pole in the transplanted kidney using color Doppler ultrasound (CDUS), power Doppler ultrasound (PDUS), and the SMI technique. The kidney size, resistive index at the level of the arcuate artery in the lower pole of the kidney, and renal artery flow rates were also measured.RESULTSThe mean distance between the kidney capsule and the vessel was 2.44 ± 2.0 mm on CDUS, 1.34 ± 1.2 mm on PDUS, 0.99 ± 1.8 mm using the color SMI (cSMI) technique, and 0.86 ± 1.8 mm using the monochrome SMI (mSMI) technique. The study found that the SMI technique was superior to CDUS and PDUS in delineating the cortical microvasculature of the kidney. Both Doppler ultrasound examinations and the SMI technique proved effective in predicting the CADI (P = 0.006 for CDUS, P = 0.002 for PDUS, P = 0.018 for cSMI, and P = 0.027 for mSMI).Among conventional Doppler ultrasound examinations and the SMI technique, PDUS had the highest sensitivity, and cSMI had the highest specificity in differentiating high and low CADI values. Both the cSMI and mSMI techniques had similar sensitivity values, whereas only cSMI exhibited high specificity. CDUS had the lowest specificity value (P = 0.003 for CDUS, P = 0.002 for PDUS, P = 0.005 for cSMI, and P = 0.004 for mSMI).CONCLUSIONThe present study is the first in the literature to demonstrate the utility of the distance between the kidney capsule and the vessels in predicting the CADI score and to compare the Doppler ultrasound examinations and SMI technique in doing so. http://www.dirjournal.org/archives/archive-detail/article-preview/a-comparison-between-the-superb-microvascular-imag/57233 chronic allograft damage indexdoppler ultrasoundkidneyrenal transplantsuperb microvascular imaging
spellingShingle Ahmet Faruk Gürbüz
Ayşe Keven
Aygül Elmalı
Serap Toru
Ali Apaydın
Kağan Çeken
A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
Diagnostic and Interventional Radiology
chronic allograft damage index
doppler ultrasound
kidney
renal transplant
superb microvascular imaging
title A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
title_full A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
title_fullStr A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
title_full_unstemmed A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
title_short A comparison between the superb microvascular imaging technique and conventional Doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
title_sort comparison between the superb microvascular imaging technique and conventional doppler ultrasound in evaluating chronic allograft damage in renal transplant recipients
topic chronic allograft damage index
doppler ultrasound
kidney
renal transplant
superb microvascular imaging
url http://www.dirjournal.org/archives/archive-detail/article-preview/a-comparison-between-the-superb-microvascular-imag/57233
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