High-Frequency US for BK Polyomavirus–associated Nephropathy after Kidney Transplant

作者：Daopeng Yang, Bowen Zhuang, Yan Wang, Gang Huang, Ming Xu, Manxia Lin, Wei Wang, Guangliang Huang, Changxi Wang, Xiaoyan Xie, Xiaohua Xie · 发表于：Radiology · 年份：2022 · DOI：10.1148/radiol.211855 · 被引用次数：6 · 研究领域：Polyomavirus and related diseases、Transplantation: Methods and Outcomes、Renal Transplantation Outcomes and Treatments

Background BK polyomavirus–associated nephropathy (BKPyVAN) is an important cause of chronic renal allograft dysfunction. However, US features indicative of BKPyVAN have not been fully evaluated. Purpose To assess the value of high-frequency US for the diagnosis of BKPyVAN in kidney transplant recipients. Materials and Methods In this prospective cohort study, participants who tested positive for BK viruria after kidney transplant from September 2019 to January 2021 were evaluated with high-frequency US 1 day before biopsy. Clinical characteristics and US features were compared between participants with and without BKPyVAN. Significant predictors associated with BKPyVAN were determined using logistic regression analyses. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance. Results A total of 105 participants who underwent kidney transplant (mean age, 38 years ± 11 [SD]; 63 men) were evaluated; 45 participants were diagnosed with BKPyVAN. Multivariable analysis demonstrated that eccentric hydronephrosis and subcapsular hypoechoic areas were independent factors for BKPyVAN. The AUC for predicting BKPyVAN according to subcapsular hypoechoic areas was 0.66 (95% CI: 0.55, 0.77), with a specificity of 92% (55 of 60 participants). The AUC of combined US (eccentric hydronephrosis plus subcapsular hypoechoic area) and clinical (urine BKPyV DNA load [BKPyV-DNA] plus BK viremia) features was 0.90, with a specificity of 92% (55 of ...