Journal Article

Renal perfusion evaluation with contrast-enhanced ultrasonography

Antoine G. Schneider, Lucie Hofmann, Grégoire Wuerzner, Nicolas Glatz, Marc Maillard, Jean-Yves Meuwly, Philippe Eggimann, Michel Burnier and Bruno Vogt

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 2, pages 674-681
Published in print February 2012 | ISSN: 0931-0509
Published online June 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr345
Renal perfusion evaluation with contrast-enhanced ultrasonography

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Background.

Contrast-enhanced ultrasonography (CEUS) is a novel imaging technique that is safe and applicable on the bedside. Recent developments seem to enable CEUS to quantify organ perfusion. We performed an exploratory study to determine the ability of CEUS to detect changes in renal perfusion and to correlate them with effective renal plasma flow.

Methods.

CEUS with destruction-refilling sequences was studied in 10 healthy subjects, at baseline and during infusion of angiotensin II (AngII) at low (1 ng/kg/min) and high dose (3 ng/kg/min) and 1 h after oral captopril (50 mg). Perfusion index (PI) was obtained and compared with the effective renal plasma flow (ERPF) obtained by parallel para-aminohippurate (PAH) clearance.

Results.

Median PI decreased from 188.6 (baseline) to 100.4 with low-dose AngII (−47%; P < 0.02) and to 66.1 with high-dose AngII (−65%; P < 0.01) but increased to 254.7 with captopril (+35%; P > 0.2). These changes parallelled those observed with ERPF, which changed from a median of 672.1 mL/min (baseline) to 572.3 (low-dose AngII, −15%, P < 0.05) and to 427.2 (high-dose AngII, −36%, P < 0.001) and finally 697.1 (captopril, +4%, P < 0.02).

Conclusions.

This study demonstrates that CEUS is able to detect changes in human renal cortical microcirculation as induced by AngII infusion and/or captopril administration. The changes in perfusion indices parallel those in ERPF as obtained by PAH clearance.

Keywords: angiotensin II; contrast-enhanced ultrasound; effective renal plasma flow; microcirculation; renal haemodynamic

Journal Article.  3929 words.  Illustrated.

Subjects: Nephrology

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