肾移植是终末期肾病的一线治疗方法。每年进行的移植手术数量不断增加，导致移植患者数量不断增加。围手术期和术后可能会出现并发症，而影像学在这种情况下起着关键作用。对比增强超声 (CEUS) 是一种安全的工具，可为超声增加附加值。造影剂通常通过静脉注射，但可以通过腔内注射造影剂来研究泌尿道解剖结构和狭窄或渗漏等并发症。用 CEUS 评估移植物和髂血管特别有助于识别血管和实质并发症，例如动脉或静脉血栓形成和狭窄、急性肾小管损伤或皮质坏死，这些可能导致移植物丢失。此外，通过超声造影可以准确地研究感染性和恶性移植物受累情况，这有助于检测肾脓肿以及区分良性和恶性疾病。 CEUS 在介入手术中也很有用，有助于引导经皮穿刺收集收集物，更好地界定移植物边界，并通过避免无血管区域来指导肾移植物活检。 CEUS 可识别潜在的术后血管并发症，如假性动脉瘤、动静脉瘘或活动性出血。此外，CEUS灌注等更新的量化工具很有前景，但需要进一步的研究来批准其用于临床目的。 ©RSNA，2024 本文提供了补充材料。

Renal transplant is the first-line treatment of end-stage renal disease. The increasing number of transplants performed every year has led to a larger population of transplant patients. Complications may arise during the perioperative and postoperative periods, and imaging plays a key role in this scenario. Contrast-enhanced US (CEUS) is a safe tool that adds additional value to US. Contrast agents are usually administered intravenously, but urinary tract anatomy and complications such as stenosis or leak can be studied using intracavitary administration of contrast agents. Assessment of the graft and iliac vessels with CEUS is particularly helpful in identifying vascular and parenchymal complications, such as arterial or venous thrombosis and stenosis, acute tubular injury, or cortical necrosis, which can lead to graft loss. Furthermore, infectious and malignant graft involvement can be accurately studied with CEUS, which can help in detection of renal abscesses and in the differentiation between benign and malignant disease. CEUS is also useful in interventional procedures, helping to guide percutaneous aspiration of collections with better delimitation of the graft boundaries and to guide renal graft biopsies by avoiding avascular areas. Potential postprocedural vascular complications, such as pseudoaneurysm, arteriovenous fistula, or active bleeding, are identified with CEUS. In addition, newer quantification tools such as CEUS perfusion are promising, but further studies are needed to approve its use for clinical purposes. ©RSNA, 2024 Supplemental material is available for this article.