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Renal allograft rejection: US evaluation.

W Hoddick, R A Filly, U Backman

    Radiology
    |November 1, 1986
    PubMed
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    Real-time ultrasonography can help detect renal allograft rejection, accurately identifying severe cases. However, differentiating mild rejection from no rejection using ultrasound remains challenging.

    Area of Science:

    • Nephrology
    • Radiology
    • Transplant Surgery

    Background:

    • Renal allograft rejection is a critical complication following transplantation.
    • Accurate and timely diagnosis of rejection is essential for graft survival.
    • Ultrasonography is a non-invasive imaging modality with potential for assessing allograft status.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of real-time ultrasonography in detecting renal allograft rejection.
    • To correlate ultrasonographic findings with histopathologic results in transplant recipients.

    Main Methods:

    • Real-time ultrasonography was performed on 100 renal allografts at the time of biopsy.
    • Sonographic parameters evaluated included renal sinus fat, allograft size, corticomedullary ratio, junctional sharpness, medullary conspicuity, parenchymal abnormalities, and wall thickening.

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  • Findings were correlated with histopathologic diagnoses.

    • Main Results:

    • Positive prediction accuracy for rejection ranged from 83% to 90%.
    • Negative prediction accuracy was low, ranging from 17% to 30%.
    • Ultrasonography struggled to differentiate mild rejection from no rejection, but severe rejection was usually distinguishable.

    Conclusions:

    • Real-time ultrasonography shows promise in identifying renal allograft rejection, particularly severe cases.
    • The modality's low negative predictive accuracy limits its ability to rule out rejection, especially mild forms.
    • Further refinement of ultrasound techniques may improve differentiation between rejection grades.