Quantitative assessment of early kidney injury using high frame rate contrast-enhanced ultrasonography in a rabbit model of diabetic nephropathy.

AIM: To explore benefits of high-frame-rate contrast-enhanced ultrasonography (H-CEUS) for early kidney injury in a rabbit model of diabetic nephropathy (DN).

METHODS: Diabetic rabbits were induced with alloxan administration and split into 2 groups with or without urinary microalbuminuria after a fatty and sugary diet: diabetic rabbits with nephropathy (Group A) and diabetic rabbits without nephropathy (Group B). The control group (Group C) comprised healthy rabbits. Renal H-CEUS and conventional CEUS (C-CEUS) imaging were conducted. Serum creatinine (SCR), blood urea nitrogen (BUN) and urinary microalbuminuria were measured.

RESULTS: SCR and BUN levels were barely changed in Groups B and C (p>0.05), whereas Group A exhibited a rise (p<0.05). Perfusion parameters of the two CEUS modalities showed reduced peak intensity (PI) and ascending slope (AS) and elevated area under the curve (AUC) and time to peak (TTP) in Group A versus Group B (p<0.05) and Group B versus Group C (p<0.05). The arrival time (AT) and descending slope (DS) exhibited little difference among the three groups. H-CEUS had a stronger correlation of perfusion parameters with SCR and BUN than C-CEUS.

CONCLUSIONS:  H-CEUS outperforms C-CEUS in diagnosing early renal damage in DN. H-CEUS perfusion parameters demonstrate temporal superiority over routine laboratory indices.