Sonographic evaluation of clinically significant perigraft hematomas in kidney transplant recipients

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to assess the sensitivity of ultrasound in evaluating peritransplant hematomas that require surgical evacuation in recipients of kidney transplants. MATERIALS AND METHODS. Thirty-four patients who underwent 37 hematoma evacuations underwent ultrasound examinations in the 24 hours before surgical evacuation. The operative reports were evaluated for presence and size of collection, presence of active bleeding at operation, and composition of the hematoma. The clinical findings leading to the ultrasound examination were recorded. Ultrasound examinations were evaluated in consensus by two board-certified and fellowship-trained abdominal radiologists for the presence, size, and echogenicity of the collection; subjective perfusion visualized with color and power Doppler ultrasound; velocities of the renal arteries; and arcuate artery resistive indexes. RESULTS. Ten of the 37 imaged hematomas (27%) had either no or small (<50 mL) fluid collections on ultrasound examination. With sonographic volumetry, the reported intraoperative volumes were underestimated by 46%. The mean arcuate artery resistive index was 0.82 in the superior pole, 0.81 in the mid pole, and 0.78 in the inferior pole of the kidney. A decrease in hemoglobin level was the most sensitive clinical finding for determining the presence of perigraft hematomas. CONCLUSION. Our results suggest that gray-scale sonography alone appears to have limited sensitivity in detecting clinically significant peritransplant hematomas and that its use may result in overall underestimates of hematomas.

Original languageEnglish (US)
Pages (from-to)802-806
Number of pages5
JournalAmerican Journal of Roentgenology
Volume205
Issue number4
DOIs
StatePublished - Oct 1 2015

Fingerprint

Hematoma
Kidney
Arteries
Doppler Ultrasonography
Renal Artery
Transplant Recipients
Ultrasonography
Hemoglobins
Color
Perfusion
Hemorrhage

Keywords

  • Hematoma
  • Renal transplant
  • Sonography
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{e54b33c39a364f03aeb47f7fe77e5565,
title = "Sonographic evaluation of clinically significant perigraft hematomas in kidney transplant recipients",
abstract = "OBJECTIVE. The purpose of this study was to assess the sensitivity of ultrasound in evaluating peritransplant hematomas that require surgical evacuation in recipients of kidney transplants. MATERIALS AND METHODS. Thirty-four patients who underwent 37 hematoma evacuations underwent ultrasound examinations in the 24 hours before surgical evacuation. The operative reports were evaluated for presence and size of collection, presence of active bleeding at operation, and composition of the hematoma. The clinical findings leading to the ultrasound examination were recorded. Ultrasound examinations were evaluated in consensus by two board-certified and fellowship-trained abdominal radiologists for the presence, size, and echogenicity of the collection; subjective perfusion visualized with color and power Doppler ultrasound; velocities of the renal arteries; and arcuate artery resistive indexes. RESULTS. Ten of the 37 imaged hematomas (27{\%}) had either no or small (<50 mL) fluid collections on ultrasound examination. With sonographic volumetry, the reported intraoperative volumes were underestimated by 46{\%}. The mean arcuate artery resistive index was 0.82 in the superior pole, 0.81 in the mid pole, and 0.78 in the inferior pole of the kidney. A decrease in hemoglobin level was the most sensitive clinical finding for determining the presence of perigraft hematomas. CONCLUSION. Our results suggest that gray-scale sonography alone appears to have limited sensitivity in detecting clinically significant peritransplant hematomas and that its use may result in overall underestimates of hematomas.",
keywords = "Hematoma, Renal transplant, Sonography, Ultrasound",
author = "Ghaneh Fananapazir and Rajiv Rao and Corwin, {Michael T} and Sima Naderi and Chandrase Santhanakrishnan and Christoph Troppmann",
year = "2015",
month = "10",
day = "1",
doi = "10.2214/AJR.15.14426",
language = "English (US)",
volume = "205",
pages = "802--806",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "4",

}

TY - JOUR

T1 - Sonographic evaluation of clinically significant perigraft hematomas in kidney transplant recipients

AU - Fananapazir, Ghaneh

AU - Rao, Rajiv

AU - Corwin, Michael T

AU - Naderi, Sima

AU - Santhanakrishnan, Chandrase

AU - Troppmann, Christoph

PY - 2015/10/1

Y1 - 2015/10/1

N2 - OBJECTIVE. The purpose of this study was to assess the sensitivity of ultrasound in evaluating peritransplant hematomas that require surgical evacuation in recipients of kidney transplants. MATERIALS AND METHODS. Thirty-four patients who underwent 37 hematoma evacuations underwent ultrasound examinations in the 24 hours before surgical evacuation. The operative reports were evaluated for presence and size of collection, presence of active bleeding at operation, and composition of the hematoma. The clinical findings leading to the ultrasound examination were recorded. Ultrasound examinations were evaluated in consensus by two board-certified and fellowship-trained abdominal radiologists for the presence, size, and echogenicity of the collection; subjective perfusion visualized with color and power Doppler ultrasound; velocities of the renal arteries; and arcuate artery resistive indexes. RESULTS. Ten of the 37 imaged hematomas (27%) had either no or small (<50 mL) fluid collections on ultrasound examination. With sonographic volumetry, the reported intraoperative volumes were underestimated by 46%. The mean arcuate artery resistive index was 0.82 in the superior pole, 0.81 in the mid pole, and 0.78 in the inferior pole of the kidney. A decrease in hemoglobin level was the most sensitive clinical finding for determining the presence of perigraft hematomas. CONCLUSION. Our results suggest that gray-scale sonography alone appears to have limited sensitivity in detecting clinically significant peritransplant hematomas and that its use may result in overall underestimates of hematomas.

AB - OBJECTIVE. The purpose of this study was to assess the sensitivity of ultrasound in evaluating peritransplant hematomas that require surgical evacuation in recipients of kidney transplants. MATERIALS AND METHODS. Thirty-four patients who underwent 37 hematoma evacuations underwent ultrasound examinations in the 24 hours before surgical evacuation. The operative reports were evaluated for presence and size of collection, presence of active bleeding at operation, and composition of the hematoma. The clinical findings leading to the ultrasound examination were recorded. Ultrasound examinations were evaluated in consensus by two board-certified and fellowship-trained abdominal radiologists for the presence, size, and echogenicity of the collection; subjective perfusion visualized with color and power Doppler ultrasound; velocities of the renal arteries; and arcuate artery resistive indexes. RESULTS. Ten of the 37 imaged hematomas (27%) had either no or small (<50 mL) fluid collections on ultrasound examination. With sonographic volumetry, the reported intraoperative volumes were underestimated by 46%. The mean arcuate artery resistive index was 0.82 in the superior pole, 0.81 in the mid pole, and 0.78 in the inferior pole of the kidney. A decrease in hemoglobin level was the most sensitive clinical finding for determining the presence of perigraft hematomas. CONCLUSION. Our results suggest that gray-scale sonography alone appears to have limited sensitivity in detecting clinically significant peritransplant hematomas and that its use may result in overall underestimates of hematomas.

KW - Hematoma

KW - Renal transplant

KW - Sonography

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=84943617740&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943617740&partnerID=8YFLogxK

U2 - 10.2214/AJR.15.14426

DO - 10.2214/AJR.15.14426

M3 - Article

C2 - 26397328

AN - SCOPUS:84943617740

VL - 205

SP - 802

EP - 806

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 4

ER -