Prediction of renal allograft chronic rejection using a model based on contrast-enhanced ultrasonography

Cheng Yang; Shengdi Wu; Ping Yang; Guoguo Shang; Ruochen Qi; Ming Xu; Ruiming Rong; Tongyu Zhu; Wanyuan He

doi:10.1111/micc.12544

Prediction of renal allograft chronic rejection using a model based on contrast-enhanced ultrasonography

Microcirculation. 2019 Aug;26(6):e12544. doi: 10.1111/micc.12544. Epub 2019 Apr 14.

Authors

Cheng Yang^{1

2}, Shengdi Wu³, Ping Yang⁴, Guoguo Shang⁵, Ruochen Qi^{1

6}, Ming Xu^{1

2}, Ruiming Rong^{1

2}, Tongyu Zhu^{1

2}, Wanyuan He⁴

Affiliations

¹ Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
² Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
³ Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁴ Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai Institute of Imaging Medicine, Shanghai, China.
⁵ Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Shanghai Medical College, Fudan University, Shanghai, China.

Abstract

Objective: To evaluate the application of contrast-enhanced ultrasonography (CEUS) for the diagnosis of renal allograft chronic rejection (CR).

Methods: A total of 104 patients who were suspected to have AR or CR were enrolled in this study (derivation group, n = 66; validation group, n = 38). Before biopsy, all patients received an ultrasound examination.

Results: In the CR group, rising time (RT) and time to peak (TTP) of medulla (RTm and TTPm, respectively) were significantly longer compared to those in the AR group. The kidney volume was significantly decreased in the CR group but was increased in the AR group. In the derivation group, age, change in kidney volume, and TTPm were identified as independent predictors by multivariate analysis. Based on the multivariate analysis results and area under receiver operating characteristic (ROC) curves (AUROCs) of individual markers, we constructed a new index as follows: P = -5.424 + 0.074 × age -9.818 × kidney volume change + 0.115 × TTPm; New Index = e^P /(1 + e^P ). The new index discriminates CR from AR and had better AUROCs than any other parameters.

Conclusion: In conclusion, the new index provides a new diagnosis model for CR.

Keywords: contrast media; diagnostic test; graft Rejection; renal transplantation; ultrasonography.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Allografts
Chronic Disease
Contrast Media / administration & dosage*
Female
Graft Rejection* / diagnostic imaging
Graft Rejection* / physiopathology
Humans
Kidney Transplantation*
Kidney* / blood supply
Kidney* / diagnostic imaging
Kidney* / physiopathology
Male
Middle Aged
Ultrasonography

Substances

Contrast Media