Gray Scale Ultrasonic Appearances of Renal Transplant Rejection

Abstract

Ultrasonic examination of renal transplants with special attention to the parenchymal echo pattern was undertaken in 43 patients. In the normal renal transplant, the pyramids, cortex and renal sinus could be distinguished. Renal transplant rejection was manifested by swelling and decreased echogenicity of the pyramids and hyperechogenic cortex. Large anechoic areas due to hemorrhagic infarcts and necrosis were seen. In long-standing rejection, a normal or small-sized kidney with an irregular intrarenal echo pattern was observed. In 13 cases of acute tubular necrosis, none of these appearances could be demonstrated. Serial ultrasonic scans were essential to reveal evolutionary changes of the rejection process.