Renal Perfusion in Scleroderma Patients Assessed by Microbubble-Based Contrast-Enhanced Ultrasound

Stefan Kleinert*, 1, Petra Roll 1, Christian Baumgaertner 1, Andrea Himsel 2, Adelheid Mueller 3, Martin Fleck 3, Martin Feuchtenberger 1, Manfred Jenett 4, Hans-Peter Tony 1
1 University Hospital of Wuerzburg, Rheumatology/Clinical Immunology, Oberduerrbacherstr. 6, D-97080 Wuerzburg, Germany
2 Klinikum der J.W. Goethe-Universitaet, Medizinische Klinik II/Rheumatologie, Theodor-Stern-Kai 7, 60590 Frankfurt am University of Regensburg and Asklepios Clinic Bad Abbach, Germany
3 University of Regensburg and Asklepios Clinic Bad Abbach, Dept. of Rheumatology and Clinical Immunology, Kaiser-Karl-V.-Allee 3, 93077 Bad Abbach, Germany
4 University Hospital of Wuerzburg, Institute of Radiology, Rheumatology/Clinical Immunology, Oberduerrbacher Str. 6, D-97080 Wuerzburg, Germany

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© Kleinert et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University Hospital of Wuerzburg, Rheumatology/Clinical Immunology, Oberduerrbacherstr. 6, D-97080 Wuerzburg, Germany; Tel: +49 931 201 40100; Fax: +49 931 201 640100; E-mail:



Renal damage is common in scleroderma. It can occur acutely or chronically. Renal reserve might already be impaired before it can be detected by laboratory findings. Microbubble-based contrast-enhanced ultrasound has been demonstrated to improve blood perfusion imaging in organs. Therefore, we conducted a study to assess renal perfusion in scleroderma patients utilizing this novel technique.

Materials and Methodology:

Microbubble-based contrast agent was infused and destroyed by using high mechanical index by Siemens Sequoia (curved array, 4.5 MHz). Replenishment was recorded for 8 seconds. Regions of interests (ROI) were analyzed in renal parenchyma, interlobular artery and renal pyramid with quantitative contrast software (CUSQ 1.4, Siemens Acuson, Mountain View, California). Time to maximal Enhancement (TmE), maximal enhancement (mE) and maximal enhancement relative to maximal enhancement of the interlobular artery (mE%A) were calculated for different ROIs.


There was a linear correlation between the time to maximal enhancement in the parenchyma and the glomerular filtration rate. However, the other parameters did not reveal significant differences between scleroderma patients and healthy controls.


Renal perfusion of scleroderma patients including the glomerular filtration rate can be assessed using microbubble-based contrast media.

Keywords: Scleroderma, renal perfusion, contrast-enhanced ultrasound..