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Power Doppler imaging of acute renal transplant rejection
M K Sidhu1, S Gambhir, R B Jeffrey
1Department of Diagnostic Imaging, Children's Hospital Oakland, California 94069, USA.
Purpose:
We evaluated the usefulness of power Doppler imaging (PDI) in diagnosing acute renal-transplant rejection.
Methods:
Twenty-eight patients underwent 33 renal-transplant biopsies for suspected acute rejection. Patterns of renal parenchymal vascularity revealed by PDI in patients with abnormal biopsy results were compared with patterns in a group who had normal biopsy results. PDI examinations were reviewed retrospectively by 2 independent radiologists who had no knowledge of the biopsy results. A PDI diagnosis of acute rejection required marked vascular pruning in both the cortex and medulla. PDI results then were compared with transplant-biopsy results.
Results:
The sensitivity and specificity of PDI for diagnosing acute renal-transplant rejection were 40% and 100%, respectively. None of the patients with negative biopsy results had PDI abnormalities. The negative predictive value of PDI was 33%, and the positive predictive value was 100%.
Conclusions:
In our study, an abnormal sonogram was highly predictive of acute transplant rejection. However, a normal sonogram did not exclude the possibility of rejection.