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Urinary Imaging

E3302. Imaging Evaluation of the Renal Transplant with Emphasis on Innovative Modalities

Deurdulian C,  Roberts A,  Tchelepi H. University of Southern California, Los Angeles, CA

Address correspondence to A. Roberts (allimcbutter@hotmail.com)

Background Information: According to the National Kidney Foundation, 17,105 renal transplants were performed in the United States in 2014. Gray scale and Doppler ultrasound is the primary imaging modality for the evaluation of renal transplants. Its lack of ionizing radiation, cost, and ability to characterize both intrinsic and vascular abnormalities make ultrasound an excellent screening modality. Recently, more advanced ultrasonographic techniques have been developed, which may allow for more accurate characterization of certain transplant complications. By employing such modalities as B-flow, contrast, and fusion to ultrasonographic surveillance, sensitivity in characterizing vascular abnormalities as well as renal and perirenal lesions are increased. B-flow ultrasound is a useful adjunct for evaluating the renal vasculature and confirming or refuting suspected Doppler sonographic findings. Contrast ultrasound allows for more accurate lesion characterization capabilities. Fusion ultrasound can be used in cases where lesion characterization is suboptimal due to a variety of factors such as body habitus, the presence of bowel gas, or the presence of intervening vessels.

Educational Goals/Teaching Points: Our aim is to provide an overview of ultrasound surveillance of renal transplants with an emphasis on newer modalities.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We present an overview of most common ultrasound renal transplant complication findings; innovative ultrasound techniques including B-flow, contrast, and fusion ultrasound; and examples where newer modalities were helpful in solving a diagnostic dilemma.

Conclusion: Newer modalities of B-flow, contrast, and fusion ultrasound may allow for more accurate surveillance in the posttransplant setting.