Renal infarct: Contrast-enhanced power Doppler sonographic findings

Power Doppler sonography (PDUS) is a promising technique for the diagnosis of renal infarcts. PDUS's efficacy may be enhanced by using sonographic con trast agents. We evaluated 3 cases of renal infarction using PDUS and the s onographic contrast agent Levovist. The findings were compared with those o f other imaging modalities, such as scintigraphy, CT, and angiography. In c ase 1, PDUS showed a patent interlobar artery only in the lower part of the right kidney and no other perfusion of the right renal parenchyma. Contras t-enhanced PDUS showed patchy areas of preserved perfusion in the lower and middle-upper anterior portions of the kidney. In case 2, PDUS showed diffu se and patchy perfusion defects in the anterolateral portion of the right k idney. On contrast-enhanced PDUS, no signal enhancement was seen in these a reas, but the perfusion defects were better delineated. In case 3, PDUS sho wed no perfusion in the upper pole of the kidney; the nonperfused area exte nded to the posterior upper portion of the kidney but could not be distingu ished from normal tissue. After injection of the contrast agent, there was no enhancement of the posterior extension of the upper pole infarct, but Do ppler signals from the surrounding normal parenchyma were enhanced, so the area was more clearly demarcated. The administration of the contrast agent facilitated the visualization of the infarcts in all 3 cases. (C) 2001 John Wiley & Sons, Inc.