La radiologia medica

, Volume 118, Issue 5, pp 837–850 | Cite as

Magnetic resonance imaging in the complications of kidney transplantation

  • M. Onniboni
  • M. De Filippo
  • R. Averna
  • L. Coco
  • M. Zompatori
  • N. Sverzellati
  • C. Rossi
Uro-Genital Radiology / Radiologia Uro-Genitale

Abstract

Kidney transplantation is currently the treatment of choice in most patients with end-stage chronic renal failure owing to the excellent results in terms of both graft and patient survival. However, surgical complications are still very frequent. Although urological (stricture, urinary fistulas, vesico-ureteral reflux) and lymphatic complications (lymphocoele) have a high incidence, they only rarely lead to graft loss. By contrast, vascular complications (stenosis, arterial and venous thrombosis, arterio-venous fistulas, pseudoaneurysms) are relatively rare, but potentially serious and may affect graft survival. Finally, medical complications such as acute tubular necrosis (ATN), rejection and de novo neoplasms may also arise in kidney transplantation. The purpose of this pictorial review is to illustrate the increasingly significant contribution of magnetic resonance angiography (MRA) in the management of complications of kidney transplantation, and emphasise how this method should now be considered a mandatory step in the diagnostic workup of selected cases. Moreover, the application and role in this setting of new magnetic resonance imaging (MRI) techniques, such as diffusion-weighted and blood oxygen level-dependent (BOLD) MRI, are also discussed.

Keywords

Magnetic resonance imaging Renal transplant Ultrasound 

La risonanza magnetica nelle complicanze del rene trapiantato

Riassunto

Il trapianto di rene rappresenta attualmente la terapia d’elezione nella maggior parte dei pazienti con insufficienza renale cronica terminale per gli eccellenti risultati di sopravvivenza dell’organo e del paziente nonostante le complicanze chirurgiche siano tuttora abbastanza frequenti. Le complicanze urologiche (stenosi, fistole urinose, reflussi vescico-ureterali) e linfatiche (linfocele), pur avendo un’incidenza significativa, raramente determinano la perdita del graft, mentre le complicanze vascolari (stenosi, trombosi arteriose e venose, fistole artero-venose, pseudo-aneurismi), relativamente rare, sono potenzialmente gravi e possono compromettere la sopravvivenza dell’organo. Esistono infine complicanze mediche quali la necrosi tubulare acuta (ATN), il rigetto e le neoformazioni de novo nel rene trapiantato. Lo scopo di questo pictorial review è quello di illustrare il contributo sempre più significativo della risonanza magnetica angiografica (MRA) nel management delle complicanze del trapianto renale, ritenendo ormai questa metodica step obbligato nell’iter diagnostico di casi selezionati. Verrà anche discusso il ruolo delle nuove tecniche di risonanza magnetica (MR), diffusione e Blood Oxygenation Level Dependent (BOLD), in questo ambito.

Parole chiave

Risonanza magnetica Trapianto renale Ecografia 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • M. Onniboni
    • 1
  • M. De Filippo
    • 1
  • R. Averna
    • 1
  • L. Coco
    • 1
  • M. Zompatori
    • 2
  • N. Sverzellati
    • 1
  • C. Rossi
    • 2
  1. 1.Scienze RadiologicheAzienda Ospedaliero-Universitaria di ParmaParmaItaly
  2. 2.Dipartimento Clinico di Scienze Radiologiche e IstocitopatologicheBolognaItaly

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