Objective

To investigate the value of microvascular flow imaging (MVFI) and contrast-enhanced ultrasound (CEUS) in the assessment of early chronic kidney disease (CKD).

Material and methods

A total of 143 patients with CKD were included in this study.

We used conventional ultrasound, MVFI, and CEUS parameters to compare patients at different stages of CKD, correlated key parameters with clinical data and histological grading, and evaluated their value for early CKD diagnosis.

Results

Parenchymal thickness and echogenicity were significantly different between groups (P < 0.001). Vascular impression, shape, and vascular index (VI) and mean intensity, mean transit time, time to peak, fall time, area under the curve (AUC_CEUS), and wash-in rate were significantly different between groups (P < 0.05). VI and AUC_CEUS were negatively correlated with blood creatinine, blood urea and histological grading, and positively correlated with estimated glomerular filtration rate, which are more effective than other positive parameters in diagnosing early CKD. The optimal diagnostic cut-off values were 55.75 for VI (AUC_ROC = 0.844; sensitivity, 75.0%; specificity, 78.8%) and 2100 for AUC_CEUS (AUC_ROC = 0.759; sensitivity, 84.1%; specificity, 71.7%), the combined use of both parameters outperforms either alone.

Conclusion

MVFI is less invasive and simpler than CEUS and is more suitable for auxiliary examination in early CKD.