The indications of ultrasound contrast agents (UCA) for liver investigations
are well systematized, with recognized benefits and limitations.
The indications are less obvious for the kidneys. Nevertheless,
UCA may provide additional relevant information for diagnosis in
selected situations. The main fields of application in contrast
enhanced ultrasound of the kidneys include exploration of the macro/
microvasculature, identification of the renal arteries, parenchymal
renal perfusion, perfusion defects, characterization of renal masses
and assessment of tumor vascularity, as well as functional studies.
UCA have no renal toxicity, are eliminated through the respiratory
system and therefore may be used in patients with renal insufficiency.
Furthermore, considering the new recommendations about the use of
gadolinium-based contrast agents in patients with severe chronic
kidney disease, UCA may be proposed in some situations as the first
choice imaging modality.
The purposes of this pictorial essay are to present the different indications
of UCA for renal investigations and to emphasize the situations
where UCA are a particularly relevant alternative imaging modality
regarding the contra-indications of iodinated or gadolinium-based
contrast agents.
Learning objectives:
1. To provide an in-depth review of highly relevant and less relevant
indications of UCA for renal investigations in a general population
2. To emphasize the possibilities of UCA as an alternative imaging
technique in cases of severe chronic kidney disease