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 language | English (US) |
|---|---|
| Pages (from-to) | 802-806 |
| Number of pages | 5 |
| Journal | American Journal of Roentgenology |
| Volume | 205 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 1 2015 |
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Keywords
- Hematoma
- Renal transplant
- Sonography
- Ultrasound
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Sonographic evaluation of clinically significant perigraft hematomas in kidney transplant recipients. / Fananapazir, Ghaneh; Rao, Rajiv; Corwin, Michael T; Naderi, Sima; Santhanakrishnan, Chandrase; Troppmann, Christoph.
In: American Journal of Roentgenology, Vol. 205, No. 4, 01.10.2015, p. 802-806.Research output: Contribution to journal › Article
}
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 -