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Published in: European Radiology 9/2013

01-09-2013 | Computed Tomography

CT perfusion technique for assessment of early kidney allograft dysfunction: preliminary results

Authors: A. Helck, M. Wessely, M. Notohamiprodjo, U. Schönermarck, E. Klotz, M. Fischereder, F. Schön, K. Nikolaou, D. A. Clevert, M. Reiser, C. Becker

Published in: European Radiology | Issue 9/2013

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Abstract

Objectives

To assess the benefit of quantitative computed tomography (CT) perfusion for differentiating acute tubular necrosis (ATN) and acute rejection (AR) in kidney allografts.

Methods

Twenty-two patients with acute kidney allograft dysfunction caused by either AR (n = 6) or ATN (n = 16) were retrospectively included in the study. All patients initially underwent a multiphase CT angiography (CTA) protocol (12 phases, one phase every 3.5 s) covering the whole graft to exclude acute postoperative complications. Multiphase CT dataset and dedicated software were used to calculate renal blood flow. Renal biopsy or clinical course of disease served as the standard of reference. Mean effective radiation dose and mean amount of contrast media were calculated.

Results

Renal blood flow values were significantly lower (P = 0.001) in allografts undergoing AR (48.3 ± 21 ml/100 ml/min) compared with those with ATN (77.5 ± 21 ml/100 ml/min). No significant difference (P = 0.71) was observed regarding creatinine level with 5.65 ± 3.1 mg/dl in AR and 5.3 ± 1.9 mg/dl in ATN. The mean effective radiation dose of the CT perfusion protocol was 13.6 ± 5.2 mSv; the mean amount of contrast media applied was 34.5 ± 5.1 ml. All examinations were performed without complications.

Conclusion

CT perfusion of kidney allografts may help to differentiate between ATN and rejection.

Key points

Quantitative CT perfusion of renal transplants is feasible.
CT perfusion could help to non-invasively differentiate AR from ATN.
CT perfusion might make some renal biopsies unnecessary.
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Metadata
Title
CT perfusion technique for assessment of early kidney allograft dysfunction: preliminary results
Authors
A. Helck
M. Wessely
M. Notohamiprodjo
U. Schönermarck
E. Klotz
M. Fischereder
F. Schön
K. Nikolaou
D. A. Clevert
M. Reiser
C. Becker
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2862-6

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