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Contrast-enhanced ultrasound of transplant organs — liver and kidney — in children

  • Contrast-enhanced ultrasound (CEUS) in children
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Abstract

Ultrasound (US) is the first-line imaging tool for evaluating liver and kidney transplants during and after the surgical procedures. In most patients after organ transplantation, gray-scale US coupled with color/power and spectral Doppler techniques is used to evaluate the transplant organs, assess the patency of vascular structures, and identify potential complications. In technically difficult or inconclusive cases, however, contrast-enhanced ultrasound (CEUS) can provide prompt and accurate diagnostic information that is essential for management decisions. CEUS is indicated to evaluate for vascular complications including vascular stenosis or thrombosis, active bleeding, pseudoaneurysms and arteriovenous fistulas. Parenchymal indications for CEUS include evaluation for perfusion defects and focal inflammatory and non-inflammatory lesions. When transplant rejection is suspected, CEUS can assist with prompt intervention by excluding potential underlying causes for organ dysfunction. Intracavitary CEUS applications can evaluate the biliary tract of a liver transplant (e.g., for biliary strictures, bile leak or intraductal stones) or the urinary tract of a renal transplant (e.g., for urinary obstruction, urine leak or vesicoureteral reflux) as well as the position and patency of hepatic, biliary and renal drains and catheters. The aim of this review is to present current experience regarding the use of CEUS to evaluate liver and renal transplants, focusing on the examination technique and interpretation of the main imaging findings, predominantly those related to vascular complications.

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Authors and Affiliations

  1. Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Doris Franke

  2. Department of Radiology and Medical Imaging, University of Virginia Children’s Hospital, Charlottesville, VA, USA

    Reza J. Daugherty & Frank M. Volberg

  3. Department of Radiology, University Children’s Hospital Ljubljana, Ljubljana, Slovenia

    Damjana Ključevšek

  4. Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Aikaterini Ntoulia & Bernarda Viteri

  5. Department of Radiology, King’s College Hospital, Denmark Hill, London, UK

    Vasileios Rafailidis

  6. Pediatric Radiology Department, Diagnósticos da America (DASA), São Paulo, Brazil

    Marcelo S. Takahashi

  7. Department of Radiology, Karolinska University Hospital, Stockholm, Sweden

    Alvaro Torres

  8. Division of Nephrology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Bernarda Viteri

  9. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Bernarda Viteri

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Franke, D., Daugherty, R.J., Ključevšek, D. et al. Contrast-enhanced ultrasound of transplant organs — liver and kidney — in children. Pediatr Radiol 51, 2284–2302 (2021). https://doi.org/10.1007/s00247-020-04867-y

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