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nyre svikt pasient
UL Colour
doppler spektral
doppler
elastografi CEUS
CT
MR biokemiske
parametre urin proslashver
ivk nuklear
medisin
biopsi
B-mode
Colour
doppler
spektral
doppler
CEUS elastografi
CT
ivk
MR
nuklear
medisin
biokemiske
parametre
urin proslashver
biopsi biopsi
nyre
kapsel pyramid
cortex
sentral sinus
kompleks
nyre sagital lengde9-
14 cm ( hoslashyre
mindre)
gt2 cm forskjell er
signifikant og boslashr
utredes
lengde korreleres til
pasientens
fenotype(hoslashyde)
lt8 cm er smaring nyre Fiorini F etal jUltrasounfacuted 2007
10161
Hvorfor ultralyd
1 Etablere og behandle aringrsak fek
hydronefrose
2Nyre biopsi ved ukjent aringrsak for svikt ved
ultralyd
3Etablere referanse maringlinger prognose
behandlingsrespons
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
B-mode
Colour
doppler
spektral
doppler
CEUS elastografi
CT
ivk
MR
nuklear
medisin
biokemiske
parametre
urin proslashver
biopsi biopsi
nyre
kapsel pyramid
cortex
sentral sinus
kompleks
nyre sagital lengde9-
14 cm ( hoslashyre
mindre)
gt2 cm forskjell er
signifikant og boslashr
utredes
lengde korreleres til
pasientens
fenotype(hoslashyde)
lt8 cm er smaring nyre Fiorini F etal jUltrasounfacuted 2007
10161
Hvorfor ultralyd
1 Etablere og behandle aringrsak fek
hydronefrose
2Nyre biopsi ved ukjent aringrsak for svikt ved
ultralyd
3Etablere referanse maringlinger prognose
behandlingsrespons
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
nyre
kapsel pyramid
cortex
sentral sinus
kompleks
nyre sagital lengde9-
14 cm ( hoslashyre
mindre)
gt2 cm forskjell er
signifikant og boslashr
utredes
lengde korreleres til
pasientens
fenotype(hoslashyde)
lt8 cm er smaring nyre Fiorini F etal jUltrasounfacuted 2007
10161
Hvorfor ultralyd
1 Etablere og behandle aringrsak fek
hydronefrose
2Nyre biopsi ved ukjent aringrsak for svikt ved
ultralyd
3Etablere referanse maringlinger prognose
behandlingsrespons
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
nyre sagital lengde9-
14 cm ( hoslashyre
mindre)
gt2 cm forskjell er
signifikant og boslashr
utredes
lengde korreleres til
pasientens
fenotype(hoslashyde)
lt8 cm er smaring nyre Fiorini F etal jUltrasounfacuted 2007
10161
Hvorfor ultralyd
1 Etablere og behandle aringrsak fek
hydronefrose
2Nyre biopsi ved ukjent aringrsak for svikt ved
ultralyd
3Etablere referanse maringlinger prognose
behandlingsrespons
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Hvorfor ultralyd
1 Etablere og behandle aringrsak fek
hydronefrose
2Nyre biopsi ved ukjent aringrsak for svikt ved
ultralyd
3Etablere referanse maringlinger prognose
behandlingsrespons
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Indikasjon for nyre
doppler
bull Nyre arterie stenose ved hypertensjon
bull Mistank om nyre infarkt
bull Vurdering av Tansplantert nyre
1Renal Ultrasound Sonography of the Kidneys Review literature (Singer et al 2006)
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
nyre diameter (cm)
sagital post-ant aksial
mean range mean range mean range
hoslashyre 10 5-116 46 37-62 47 39-62
venstre 105 81-
127 48 37-63 48 37-75
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue
2 1 April 2008
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Parenchym
tykkelse(cm)
oslashvre pol medium cortex nedre pol-
mean range mean range mean range
hoslashyre 144 1-19 143 09-19 15 12-2
venstre 152 13-19 139 11-2 141 119
Renal ultrasound in acute kidney injury long-term findings
Maite Rivera Belen Ponte Carmen Felipe Fernando LiantildeoJoaquiacuten OrtuntildeoNDT Plus Volume 1 Issue 2 1 April 2008
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Cortex tykkelse korrilerer bra med nyre funksjon 1
Linear sterk korrelasjon
1 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it
better than renal length as an indicator of renal function in chronic kidney disease AJR Am J
Roentgenol 2010195W146-9
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
columna Bertini
Cortex og columna
Bertini atrofioslashkt fett i
sinus 1
1 Buturovic-Ponikvar J Visnar-Perovic A Ultrasonography in chronic renal
failure Eur J Radiol 200346115-22
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Kronisk nyre svikt
(CRF)
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
kronisk nyre svikt 1 Hyperekkogenisitetinterstisiell Oslashdem fibrose
sklerose
2 Redusert stoslashrrelse
3Manglende parenchym sinus differensiering 1
4 Progressiv reduksjon i cortex tykkelse
korrelerer med nyresvikt graden2
1Tarzamni MK Nezami N Rashid RJ et al Anatomical differences in the right and left renal arterial patterns Folia Morphol
(Warsz) 200867104-10
2 Beland MD Walle NL Machan JT et al Renal cortical thickness measured at ultrasound is it better than renal length as
an indicator of renal function in chronic kidney disease AJR Am J Roentgenol 2010195W146-9
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
On the other hand it should be remembered that up to 20 of diabetic patients have renal failure resulting from causes
not directly related to the disease For example renal artery stenosis is three times more frequent in diabetic patients
Vascular diseases affecting the microvasculature (hypertensive nephrosclerosis) or the renal macrovasculature (ischemic
renal disease) represent other possible causes of CRI in this group of patients and as previously mentioned these diseases
also cause renal cortex thinning(11)
1Tynne corex og
columna bertini
Untatt DM nefropati1
2Oslashkt fett innhold i
sinusmanglende
differensiering
3Lengde
1Sanusi AA Arogundade FA Famurewa OC et al Relationship of ultrasonographically
determined kidney volume with measured GFR calculated creatinine clearance and other parameters in chronic kidney disease (CKD) Nephrol Dial Transplant 2009241690-4
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
hydronefrose
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Normal elastografi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Differensiell diagnose av nyresykdommer
Normal ekkogenitet med normal eller oslashkt nyrestoslashrrelse Normal eller oslashkt ekkogenitet med oslashkt nyrestoslashrrelse og nedsatt
nyrefunksjon
Tidlig diabetisk nephropati GN
Normal ekkogenitet med oslashkt nyrestoslashrrelse og normal nyrefunksjon Vaskulitt
steroid bruk Tubulointerstitial sykdom ( feks Akutt interstitial
nephritis)
fedme amyloid
Hoslashy statur myelom
akromegali HIV nefropati
diabetes Svangerskapsforgiftning
Asymptomatisk ensidig oslashkning i nyre stoslashrrelse Oslashkt medullaeligr ekkogenitet med normal cortex
Hypertrofi fra nedsatt funksjon av annen nyre Medulaeligr nefrokalsinose
Renal duplisering anomali Tamm Horsfall protein i tubules
Lymfom leukemi (vanligvis paringvirker begge nyrer) Urat nefropati
Symptomatisk ensidig oslashkning i nyre stoslashrrelse Syklecellesykdom
pyelonefritt Sjoumlgrens syndrom
Akutt vaskulaeligr fornaeligrmelse ( feks Trombose i renal vene) Medullary svamp nyre
Urinveisobstruksjon Redusert kortikal ekkogenitet ( dvs moslashrk cortex)
Akutt kortikal nekrose
oslashdem
TekstDifferensial diagnose av nyresykdommer basert paring nyre stoslashrrelse ekkogenitet og symptomer
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Nyre svikt har ikke spesifikk utseende ved
ultralyd
MEN
Lengde
Corticomedullaeligr differensiering
Cortical og parenkym tykklese
Ekkogenisitet
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Renal amyloidose
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
DM
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
RAS
oslashkt PSV gt15-18
msekmed
poststenotisk
turbulans
intrarenal
parvus tardus(ikke
fast systolisk
oppstroke)
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Indicies blir ikke patologiske med verdier av
nyre arterie stenose under 70-80
Abdominal ultrasound HowJane Bates 2011 chapter 7
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Akutt nyre svikt
Parametre
Lengde
Parenchym hoslashyde
Parenchym ekkogenisitet
Differensiering (cortx medulla)
Cyster konkrementer
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
J Clin Diagn Res 2016 Feb 10(2) TC09ndashTC11
Published online 2016 Feb 1 doi 107860JCDR2016169867233
PMCID PMC4800621
A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure
Ozmen CA1 Akin D Bilek SU Bayrak AH Senturk S Nazaroglu H
Author information
Abstract
AIM
Renal ultrasound (US) is the most appropriate method for imaging renal failure however
considerable overlap in renal size and renal echogenicity exists between normally and
abnormally functioning kidneys We compared the sonographic features of kidneys in patients
with renal failure to investigate the potential role of renal US to distinguish acute from chronic
renal failure and assessed the diagnostic role of body surface area-corrected renal length
compared to measured renal length
MATERIALS AND METHODS
We included 127 consecutive patients with serum creatinine levels higher than 3 mgdl and 33
healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF)
were compared for renal length parenchymal thickness parenchymal echogenicity distinctness
of the corticomedullary junction and the presence of stones and cysts
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
CONCLUSIONS
Renal length parenchymal thickness and
echogenicity differed significantly between
patients with acute and chronic renal
failure A renal US examination is still the
most appropriate method for imaging renal
failure and should be combined with other
tests to distinguish acute from chronic
renal failure
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Lengde og
parenchym tykkelse
er stoslashrre i ARF
sammenlignet med
CRF(plt00001)
ARF = kontroll
gruppe
Grad 1 ekkogenisitet
er hyppigeste
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Nyre stoslashtrrelse
AlderkjoslashnnDM Hoslashyde(BSA)surface area
DM nyre har bedre utseende enn tilsvarende
CRF nyre grunnet andre aringrsakerek redusert
cortex er mer utalt i hypertensiv nefropati
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
ARF CRF KONTROLL P HOslashNYRE LENGDE
MM 112 +- 14 90 +-15 106 +-7 lt00001 VENYRE LENGDE
MM 112 +- 14 91 +-16 108 +-7 lt00001
HOslashPARENCH
TYKKMM
138 +-
35 109 +-45 137 +-14 lt00001
VEPARENCHTYKK
MM
137 +-
35
106 +-
46 136 +-15 lt00001
GJENNOMSNITT
NYRE LENGDE MM 112 +- 14 90 +-15 107 +- 6 lt00001
GJENNOMSNITT
PARENCH TYKK MM
137 +-
34 107 +-42 136 +-14 lt00001
BSA KORRIGERT
MED NYRE LENGDEN 116 +- 16 91 +-15 106 +-10 lt00001
BSA KORRIGERT
MED PARENCH
TYKK KORRIGERT
MED NYRE
LENGDEN
142 +-
31 108 +-41 134 +-16 lt00001
VECM DIFFER 903 600 848 lt00001
HOslash CM DIFF 871 631 879 0002
CYSTER 145 308 151 0029
KONKREMENT 210 200 188 ns
EKTASI 161 123 0 ns
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
hoslashkortikal
ekkogen ARF CRF kontroll p
grad 0 19 4 27
lt00001
grad I 33 32 6
grad II 10 27 0
grad III 0 7 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
vekortikal
ekkoge ARF CRF kontroll p
grad 0 23 3 28
lt00001
grad I 35 36 5
grad II 4 21 0
grad III 0 5 0
Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure CAOzman clinicalnephrologyvolume
74NO12010(46-52)
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
parenchym tykkelse
ARF14 mm(138 +- 34)
CRF 9 mm (107 +-42)
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
CM differensiering
Cyster hyppigere ved CRF vs ARF
(308-145)
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
DM
Lengde parenchym tykkelse
DM 1003 +-157 142 +-35
CRF 799 +-84 93 +-36
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Kropsvekt korrigert med lengde sensitivitet paring
824spesifisitet 758 cut off
685mm(plt0001)
Kropsvekt korrigert mot parenchym
sensit559 spesifis 921(plt0001)
Begge(L+parenchym)sensit706
spesifis842cut off 107 mm
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Forskjell mellom ---BSA korrigert lengde og
parenchym tykkese var 0010 og 0008 respektivt
Ikke stor klinisk betydning
Kun i ekstrem hoslashyde og vekt
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Correlation Between the Resistive Index by Doppler Ultrasound
and Kidney Function and Histology
Ryota Ikee MD Shuzo Kobayashi MD PhD
Correspondence information about the author MD PhD Shuzo Kobayashi
Email the author MD PhD Shuzo Kobayashi Noriaki Hemmi MD Toshihiko Imakiire MD Yuichi Kikuchi MD Hidekazu Moriya MD Shigenobu Suzuki MD Soichiro Miura MD Department of Nephrology and Kidney and Dialysis Center Shonan Kamakura General Hospital Kanagawa and Second Department of Internal Medicine National Defense Medical College
Saitama Japan
PlumX Metrics DOI httpsdoiorg101053jajkd200506006 bull
Background Although duplex Doppler ultrasonography has been used widely it still is unknown whether resistive index could be related directly to vascular or tubulointerstitial changes in the kidney Methods Thirty-three patients who underwent renal biopsy were included in the present study Clinical data including sex age time from abnormal urinalysis result to biopsy serum creatinine level creatinine clearance urinary excretion of protein N-acetyl-β-glucosaminidase and urinary β2-microglobulin and presence of hypertension were recorded at biopsy Histopathologic data including glomerular sclerosis interstitial fibrosistubular atrophy interstitial infiltration and arteriolosclerosis were evaluated separately by means of a quantitative or semiquantitative method We examined whether resistive index at biopsy was related to these clinical and histopathologic parameters and moreover to renal outcome in patients followed up for more than 2 years Results Age creatinine clearance urinary β2-microglobulin excretion and all histopathologic parameters showed statistically significant correlations with resistive index However stepwise multiple regression analysis showed that only arteriolosclerosis was chosen as an independent risk factor for increased resistive index During the follow-up period of 575 plusmn 156 months in 29 patients 8 patients (276) had progression of renal impairment defined as an increase in serum creatinine level greater than 50 They had a significantly increased resistive index at biopsy compared with patients without progression Conclusion We show a direct relationship between resistive index and arteriolosclerosis in damaged kidneys Resistive index at renal biopsy may be useful as one of the prognostic markers for renal outcome
We show a direct relationship between resistive index and arteriolosclerosis in damaged
kidneys Resistive index at renal biopsy may be useful as one of the prognostic
markers for renal outcome
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
bull ellipsoid formula (V = craniocaudal
diameter times anteroposterior diameter times transverse
diameter times 05233) [5] subsequently adjusted to the
patients body mass index (BMI) using the
formula VBMI times 25This formula indicates the
appropriate renal volume with mean values of
231 plusmn 505 ml [6] Increased renal volume correlates
with anatomic-pathological conditions implying
kidney hypertrophy protein deposits fluid
collections in the interstitial space or in the tubules
cellular infiltration and neoplastic lesions with
necrotic areas
Apart from its renal prognostic role high RRIs (ie gt080) have been reported to be predictive of all-cause mortality in CKD patients
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
bull RIgt 08 i CRF predikerer nefropati progresjon bedre
enn creatinin clearance og protein uri
bull Sensitivitet og spesifisitet paring 64 og 98 respektivt
bull 1Radermacher J Ellis S Haller H Renal resistance index and progression of renal disease Hypertension 200239699ndash
703
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
ARF
bull Non-obstructive ARF can be caused by numerous
pathologies but intraparenchymal renal RI values are
always elevated in ATN and also in 50 of cases
which cannot be diagnosed as ATN (acute
glomerulonephritis interstitial nephritis lupus
nephritis lymphoma etc)1
bull 1Platt JF Rubin JM Ellis JH Acute renal
failure possible role of duplex Doppler US in
distinction between acute prerenal failure and acute
tubular necrosis Radiology 1991179419ndash423
bull Color Doppler cannot establish the origin of ATN as
increased intrarenal RI values are found in
hypovolemia rhabdomyolysis sepsis nephrotoxic
substances and multiple organ failure RI oslashker
tidelig (maks nivaring innen 12 timer)foslashr screatinin (
etter 24 timer) RI normaliseres innen 1 uker hvis
behandlet aringrsak screatining normaliseres innen 2
uker
bull RI oslashker tidelig (maks
nivaring innen 12
timer)foslashr screatinin (
etter 24 timer) RI
normaliseres innen 1
uker hvis behandlet
aringrsak screatining
normaliseres innen 2
uker
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
ARF 2
bull Kun 11 med ARF har morfologisk B-mode
forandringer
bull 69 viser avvikende nyre blod flow med patologisk
intraparenchymal RI 1
bull 1Platt JF Rubin JM Ellis JH Acute renal failure possible role of duplex Doppler US in distinction between acute
prerenal failure and acute tubular necrosis Radiology 1991179419ndash423
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
RI
bull Standard 05-07
bull lt05 i nyre arteire stenose
bull gt07 eller side forskjell paring gt01 i hydronefrose
intrensik sykdom renal astenose DM etter
mikroalbuminuri eller transplant rejeksjon
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
sensitivitet spesifisitet
RI gt07 68 69
u protein gt10 gg
creatinin
77 64
systolisk blod
trykkgt140 mmHg
69 65
TekstResistive index predicts renal prognosis in chronic kidney disease
Toshihiro Sugiura Akira Wada
Nephrology Dialysis Transplantation Volume 24 Issue 9 1 September 2009 Pages 2780ndash
2785 httpsdoiorg101093ndtgfp121
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
CEUS
bull Color and power Doppler can provide an accurate
morphological and functional evaluation of the
intraparenchymal vascularity and detect reduced or no blood
flow in the kidney or in a portion of the kidney In this case
there will be color signals from the undamaged part of the
kidney but not from the ischemic part The use of contrast
agent increases diagnostic confidence in this type of lesions 1
bull RI is commonly used for evaluating renal arterial resistance
and a significant correlation between RI and renal vascular
resistance is repeatedly reported in the literature2
bull 1Yucel C Ozdemir H Akpek S Gurel K Kapucu LO
Arac M Renal infarct contrast-enhanced power Doppler
sonographic findings J Clin Ultrasound 200129237ndash242
bull 2Sauvain JL Bourscheid D Duplex Doppler sonography of
intrarenal arteries Normal and pathological aspects Ann
Radiol 199134237ndash247
Doppler=Morfologi
RI=Nyre arterie resistens
CEUS= Confidence
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
Doppler
RI
CEUS
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
CEUS indikasjon
bull 1Vurdering av
forverring av nyre
funksjon(fekinfarkt)
bull 2Fokal nyre lesjon
karakterisering
Bertolotto M Martegani A Aiani L et al Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast enhanced
CT A feasibility study Eur Radiol 2007 18 376ndash383
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
bull renal infarkt
bull cortical nekrose
bull renal ischemi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
bull CEUS identifiserer 36 av nyre infarkt VS 10
med kun doppler
bull p=00002
bull Resten uditektert aringrsak
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
World J Radiol 2017 Jan 28 9(1) 10ndash16
Published online 2017 Jan 28 doi 104329wjrv9i110
Impact of contrast-enhanced ultrasound in patients with renal function impairment
Rossano Girometti Tiziano Stocca Elena Serena Antonio Granata and Michele Bertolotto
Author information Article notes Copyright and License information
In conclusion our study shows that CEUS has a significant role as a problem-solving technique for detection of perfusion abnormalities and characterization of renal lesions in patients with renal failure CEUS can be performed in emergency at the bedside In our series it was helpful in stratifying treatment decisions as shown by the fact that all patients with suspicious renal cancer in whom surgery was not contraindicated were operated properly
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
fokal lesjoner og CEUS
bull 41 lesjoner
bull 21 solide(51) 20(488 var Bosniak cyster)
bull 12 v 21 solide fjernet=RCC
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
oppsummering
bull UL
bull DM
bull Doppler (RI)
bull Andre metoder
bull Elsatografi CEUSScintigrafi
bull Biopsi
![Almen kirurgi - 3 synopse [Kompatibilitetstilstand]odont.au.dk/fileadmin/ · • Cornea (grå stær) • Nyre • Hjerte • Hjerte-lungeblok • Lever Organtransplantationer •](https://img.dokumen.tips/doc/110x75/5cbebbee88c993d1388b47c6/almen-kirurgi-3-synopse-kompatibilitetstilstandodontaudkfileadmin-.jpg)
