ARRS 2022 Abstracts

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E1561. Contrast-Enhanced Ultrasound in the Evaluation of Renal Allografts: A Safe, Accurate, and Inexpensive Modality
Authors
  1. Nicole Markwith; Virginia Commonwealth University
  2. Shyann Smith; Virginia Commonwealth University
  3. Dhiren Kumar; Virginia Commonwealth University
  4. Ryan Clayton; Virginia Commonwealth University
  5. Uma Prasad; Virginia Commonwealth University
Background
Contrast-enhanced ultrasound (CEUS) is a relatively new imaging modality that offers safe, accurate, and inexpensive evaluation of the liver and kidney. Its safety profile and accessibility have led to an increase in its utilization, particularly for the evaluation of renal allograft complications. CEUS utilizes tiny microbubbles that, when injected intravenously, dramatically enhance acoustic backscatter as blood courses through tissues. This enhanced interface allows for real-time evaluation of renal lesions, renal parenchyma, and renal allograft vasculature. The microbubbles have a short half-life, are exhaled through the lungs, and produce no ionizing radiation. They pose neither hepatic nor renal toxicity, making CEUS an excellent option for patients with an iodinated contrast allergy, poor renal function, or other contraindication to either CT or MRI.

Educational Goals / Teaching Points
In this exhibit, we discuss the benefits of CEUS in evaluating renal allograft architecture and vascular dynamics easily, safely, and non-invasively. We illustrate several allograft pathologies on CEUS using real case examples.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We routinely utilize CEUS at our institution, having performed over 100 CEUS examinations on transplanted kidneys alone. We have made definitive diagnoses without the need for iodinated contrast material or ionizing radiation. This new and exciting technique has allowed us to diagnose many interesting pathologies including complete and partial renal infarcts, transplant renal artery stenosis, aneurysms, and pseudoaneurysms, intra- and extra-renal vein thromboses, benign and malignant tumors, and much more. Increased awareness of CEUS as a tool for allograft evaluation will facilitate accurate diagnosis and decrease unnecessary imaging without exposing patients to iodinated contrast or ionizing radiation.

Conclusion
CEUS offers rapid, accurate, safe, and inexpensive evaluation of the renal allograft.