Die Transplantatniere: Farbkodierte Duplex-Sonographie und kontrastmittelverstärkte Sonographie in der Beurteilung nephrologischer und chirurgischer Komplikationen

Zusammenfassung

Die USKM-gestützte Sonographie ist eine viel versprechende, einfach durchzuführende Methode, die den bislang üblichen Verfahren wie der konventionellen B-Mode-Sonographie (Volumenmessung, Hämatomnachweis) und Farbdoppler-Untersuchung (Rejektionsdiagnostik, Perfusionsdefekt, Vaskularisation) bei der Transplantatnierenbeurteilung gegenübergestellt werden kann. Die Methode hat zusätzliches Potenzial bei der Dignitätseinschätzung von tumorösen Strukturen im Transplantat. In einem Untersuchungsgang können mittels USKM-Sonographie unterschiedlichste Fragestellungen der frühen postoperativen Phase und der Langzeitnachsorge betrachtet werden. Charakteristische Anflutkurven bei vaskulärer Rejektion führen in ersten klinischen Studien zur effizienten und zeitnahen Beurteilung der Transplantatniere. Auch chirurgische Komplikationen wie der Perfusionsdefekt oder das postoperative Hämatom können detektiert werden. Die Perfusionswirksamkeit eines Hämatoms kann abgeschätzt werden.

Abstract

Contrast ultrasound is a promising and straightforward method that is superior to established sonographic techniques such as conventional B-mode scanning which is used for volume measurement and hematoma demonstration. Color Doppler is important for the evaluation of rejection, the detection of perfusion defects, and complete vascularization in the diagnostic evaluation of kidney grafts. Moreover, contrast US has the potential for tumor characterization in transplanted kidneys. A single examination by contrast ultrasound can answer a variety of questions with respect to the early postoperative phase and chronic damage. New applications of contrast US will arise from the further technical development of ultrasound equipment. The rapid technical advances seen in recent years have been followed by the introduction of new software tools for the analysis of raw datasets or the improved visualization of microbubbles at very low energy. Initial studies show that efficient and early diagnosis of rejection is possible. Surgical complications like perfusion defects or hematoma can also be identified.

Key words

Color duplex ultrasound - kidney transplant - contrast agent

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