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Prediction of renal allograft chronic rejection using a model based on contrast‐enhanced ultrasonography
Author(s) -
Yang Cheng,
Wu Shengdi,
Yang Ping,
Shang Guoguo,
Qi Ruochen,
Xu Ming,
Rong Ruiming,
Zhu Tongyu,
He Wanyuan
Publication year - 2019
Publication title -
microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.793
H-Index - 83
eISSN - 1549-8719
pISSN - 1073-9688
DOI - 10.1111/micc.12544
Subject(s) - receiver operating characteristic , medicine , ultrasonography , urology , multivariate analysis , contrast enhanced ultrasound , gastroenterology , surgery
Objective To evaluate the application of contrast‐enhanced ultrasonography ( CEUS ) for the diagnosis of renal allograft chronic rejection ( CR ). Methods A total of 104 patients who were suspected to have AR or CR were enrolled in this study (derivation group, n = 66; validation group, n = 38). Before biopsy, all patients received an ultrasound examination. Results In the CR group, rising time ( RT ) and time to peak ( TTP ) of medulla ( RT m and TTP m, respectively) were significantly longer compared to those in the AR group. The kidney volume was significantly decreased in the CR group but was increased in the AR group. In the derivation group, age, change in kidney volume, and TTP m were identified as independent predictors by multivariate analysis. Based on the multivariate analysis results and area under receiver operating characteristic (ROC) curves ( AUROC s) of individual markers, we constructed a new index as follows: P = −5.424 + 0.074 × age −9.818 × kidney volume change + 0.115 × TTP m; New Index = e P /(1 + e P ). The new index discriminates CR from AR and had better AUROC s than any other parameters. Conclusion In conclusion, the new index provides a new diagnosis model for CR .