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Evaluation of Renal Microcirculation by Contrast-Enhanced Ultrasound With SonazoidTM as a Contrast Agent Comparison Between Normal Subjects and Patients With Chronic Kidney Disease
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- Tsuruoka Kayori
- Department of Nephrology and Hypertension, Internal Medicine
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- Yasuda Takashi
- Department of Nephrology and Hypertension, Internal Medicine
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- Koitabashi Kenichiro
- Department of Nephrology and Hypertension, Internal Medicine
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- Yazawa Masahiko
- Department of Nephrology and Hypertension, Internal Medicine
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- Shimazaki Minako
- Department of Nephrology and Hypertension, Internal Medicine
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- Sakurada Tsutomu
- Department of Nephrology and Hypertension, Internal Medicine
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- Shirai Sayuri
- Department of Nephrology and Hypertension, Internal Medicine
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- Shibagaki Yugo
- Department of Nephrology and Hypertension, Internal Medicine
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- Kimura Kenjiro
- Department of Nephrology and Hypertension, Internal Medicine
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- Tsujimoto Fumio
- Department of Clinical Laboratory Medicine, St. Marianna University School of Medicine
Bibliographic Information
- Other Title
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- Comparison Between Normal Subjects and Patients With Chronic Kidney Disease
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Description
Chronic kidney disease (CKD) is a major and serious risk factor for cardiovascular disease (CVD). Continuous hypoxia due to hypoperfusion in peritubular capillaries is one of the factors aggravating CKD, but evaluation of perfusion in this region is difficult using clinically available imaging methods. Since the second-generation ultrasound contrast agent SonazoidTM has a stable shell, it enables visualization of the renal vasculature for a long period of time. We therefore evaluated changes in contrast-enhanced ultrasound (CEUS) imaging with SonazoidTM in CKD patients.<br>SonazoidTM was used in 85 CKD patients and 5 control subjects, and images were recorded for 10 minutes. Time-intensity curves were generated from the images of 62 time points in both cortex and medulla.<br>In control samples, contrast enhancement spread from the hilar portion to the periphery along the direction of arterial flow, and renal cortex and medulla were then enhanced in sequence. Enhancement was maximal soon after, then gradually decreased, but was still visible at 600 seconds. In CKD patients, renal contrast enhancement was attenuated in both cortex and medulla. On time-intensity curves, the attenuation of enhancement was composed of delayed rising, reduction of peak, and acceleration of decay in both cortex and medulla with progression of renal dysfunction. No side effects of the contrast agent were observed in any subjects.<br>The attenuation of renal contrast enhancement observed in CKD patients appears to reflect disturbance of perfusion in peritubular capillaries. CEUS with SonazoidTM is a useful and safe means of visualizing the renal microvasculature.
Journal
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- International Heart Journal
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International Heart Journal 51 (3), 176-182, 2010
International Heart Journal Association
