Role of multi-parametric ultrasonography for the assessment and monitoring of functional status of renal allografts with histopathological correlation

Figure 1 Study population inclusion process. BMI: Body mass index.

Figure 2 Graphical representation of linear regression analysis of kPa values of parenchymal stiffness. A: Serum creatinine; B: Estimated glomerular filtration rate (eGFR).

Figure 3 Graphical representation of linear regression analysis of interlobar artery resistive index values. A: Serum creatinine; B: Estimated glomerular filtration rate (eGFR).

Figure 4 Receiver operating characteristic analysis between acute graft dysfunction and stable grafts based on serum creatinine levels. ROC: Receiver operating characteristic.

Figure 5 Quantitative elastography measurement at the interpolar region of a transplant kidney with acute allograft dysfunction due to acute tubular necrosis. A: Gray scale image; B: Color-coded map elasticity values distribution on a scale of 0 to 80 kPa and corresponding gray scale image (mean value 350 kPa and 3.4 m/s); C: Histopathological section shows acute tubular injury with dilation of tubules (blue arrow) and flattening of tubular epithelial cells (orange arrow; × 100 original magnification, H&E stain, scale bar = 100 μm).

Figure 6 Quantitative elastography measurement at the interpolar region of a transplant kidney with acute allograft dysfunction due to acute cellular rejection. A: Gray scale image; B: Color-coded map of elasticity value distribution on a scale of 0 to 80 kPa and corresponding gray scale image (mean value 346 kPa and 3.4 m/s); C: Histopathological section shows severe tubulitis (blue arrow) along with tubulo-interstitial inflammation (black arrow) and interstitial edema (white arrow) in a case of Acute T cell Mediated Cellular Rejection Banff Grade IB (× 100 original magnification, PAS stain, scale bar = 100 μm).

Figure 7 Quantitative elastography measurement at the interpolar region of a transplant kidney with acute allograft dysfunction due to calcineurin inhibitor toxicity. A: Gray scale image; B: Color-coded map of elasticity value distribution on a scale of 0 to 80 kPa and corresponding gray scale image (mean value 331 kPa and 3.3 m/s); C: Histopathological section shows features of CNI toxicity in form of beaded nodular adventitial fibrosis (green arrow) from a case of renal allograft recipient (× 400 original magnification, PAS stain, scale bar = 200 μm).