1.Novel non-invasive and quantitative assessment of the renal function of transplanted kidneys using Doppler ultrasonography with the vascular index of superb microvascular imaging
Sung Hwan BAE ; Eun Ji LEE ; Jiyoung HWANG ; Seong Sook HONG ; Yun-Woo CHANG ; Boda NAM
Ultrasonography 2025;44(2):160-169
Purpose:
This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys.
Methods:
This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VIbox, VIF1, VIF2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR.
Results:
Significant differences in VI were observed among CKD groups based on eGFR (VIbox, P=0.001; VIF1, P<0.001; VIF2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VIbox, P=0.039; VIF1, P=0.001; VIF2, P<0.001). VIF1 and VIF2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VIbox moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VIF2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR.
Conclusion
The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VIF2) is highly reproducible and correlates well with eGFR. Both VIF2 and ACR independently predict eGFR.
2.Novel non-invasive and quantitative assessment of the renal function of transplanted kidneys using Doppler ultrasonography with the vascular index of superb microvascular imaging
Sung Hwan BAE ; Eun Ji LEE ; Jiyoung HWANG ; Seong Sook HONG ; Yun-Woo CHANG ; Boda NAM
Ultrasonography 2025;44(2):160-169
Purpose:
This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys.
Methods:
This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VIbox, VIF1, VIF2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR.
Results:
Significant differences in VI were observed among CKD groups based on eGFR (VIbox, P=0.001; VIF1, P<0.001; VIF2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VIbox, P=0.039; VIF1, P=0.001; VIF2, P<0.001). VIF1 and VIF2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VIbox moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VIF2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR.
Conclusion
The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VIF2) is highly reproducible and correlates well with eGFR. Both VIF2 and ACR independently predict eGFR.
3.Outcomes of pancreas transplantation over two decades:a single-center retrospective cohort study
Jiyoung SHIN ; Hye Young WOO ; Eun-Ah JO ; Ara CHO ; Ahram HAN ; Sanghyun AHN ; Sangil MIN ; Jongwon HA
Annals of Surgical Treatment and Research 2025;108(5):271-278
Purpose:
Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival.
Methods:
A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death.
Results:
Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045).
Conclusion
PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.
4.Novel non-invasive and quantitative assessment of the renal function of transplanted kidneys using Doppler ultrasonography with the vascular index of superb microvascular imaging
Sung Hwan BAE ; Eun Ji LEE ; Jiyoung HWANG ; Seong Sook HONG ; Yun-Woo CHANG ; Boda NAM
Ultrasonography 2025;44(2):160-169
Purpose:
This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys.
Methods:
This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VIbox, VIF1, VIF2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR.
Results:
Significant differences in VI were observed among CKD groups based on eGFR (VIbox, P=0.001; VIF1, P<0.001; VIF2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VIbox, P=0.039; VIF1, P=0.001; VIF2, P<0.001). VIF1 and VIF2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VIbox moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VIF2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR.
Conclusion
The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VIF2) is highly reproducible and correlates well with eGFR. Both VIF2 and ACR independently predict eGFR.
5.Anatomical Variations, Genitourinary Anomalies and Clinical Presentations in Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: Case Series
Hyun Jeong KIM ; Eun Ji LEE ; Yun-Woo CHANG ; Seong Sook HONG ; Jiyoung HWANG ; Boda NAM ; Sung Hwan BAE
Journal of the Korean Society of Radiology 2025;86(1):129-140
Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare Müllerian duct anomaly, commonly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. While these are the three most common genitourinary anomalies in OHVIRA syndrome, a spectrum of urogenital anomalies can be present. Knowledge of this spectrum is crucial for proper patient management and treatment planning. In this case series, we report on five patients with OHVIRA syndrome, each presenting with a urogenital anomaly other than the typical renal agenesis or uterus didelphys. We highlight the gynecological complications encountered, which clinicians and radiologists should be aware of.
6.Outcomes of pancreas transplantation over two decades:a single-center retrospective cohort study
Jiyoung SHIN ; Hye Young WOO ; Eun-Ah JO ; Ara CHO ; Ahram HAN ; Sanghyun AHN ; Sangil MIN ; Jongwon HA
Annals of Surgical Treatment and Research 2025;108(5):271-278
Purpose:
Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival.
Methods:
A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death.
Results:
Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045).
Conclusion
PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.
7.Anatomical Variations, Genitourinary Anomalies and Clinical Presentations in Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: Case Series
Hyun Jeong KIM ; Eun Ji LEE ; Yun-Woo CHANG ; Seong Sook HONG ; Jiyoung HWANG ; Boda NAM ; Sung Hwan BAE
Journal of the Korean Society of Radiology 2025;86(1):129-140
Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare Müllerian duct anomaly, commonly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. While these are the three most common genitourinary anomalies in OHVIRA syndrome, a spectrum of urogenital anomalies can be present. Knowledge of this spectrum is crucial for proper patient management and treatment planning. In this case series, we report on five patients with OHVIRA syndrome, each presenting with a urogenital anomaly other than the typical renal agenesis or uterus didelphys. We highlight the gynecological complications encountered, which clinicians and radiologists should be aware of.
8.Novel non-invasive and quantitative assessment of the renal function of transplanted kidneys using Doppler ultrasonography with the vascular index of superb microvascular imaging
Sung Hwan BAE ; Eun Ji LEE ; Jiyoung HWANG ; Seong Sook HONG ; Yun-Woo CHANG ; Boda NAM
Ultrasonography 2025;44(2):160-169
Purpose:
This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys.
Methods:
This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VIbox, VIF1, VIF2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR.
Results:
Significant differences in VI were observed among CKD groups based on eGFR (VIbox, P=0.001; VIF1, P<0.001; VIF2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VIbox, P=0.039; VIF1, P=0.001; VIF2, P<0.001). VIF1 and VIF2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VIbox moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VIF2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR.
Conclusion
The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VIF2) is highly reproducible and correlates well with eGFR. Both VIF2 and ACR independently predict eGFR.
9.Outcomes of pancreas transplantation over two decades:a single-center retrospective cohort study
Jiyoung SHIN ; Hye Young WOO ; Eun-Ah JO ; Ara CHO ; Ahram HAN ; Sanghyun AHN ; Sangil MIN ; Jongwon HA
Annals of Surgical Treatment and Research 2025;108(5):271-278
Purpose:
Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival.
Methods:
A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death.
Results:
Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045).
Conclusion
PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.
10.Anatomical Variations, Genitourinary Anomalies and Clinical Presentations in Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: Case Series
Hyun Jeong KIM ; Eun Ji LEE ; Yun-Woo CHANG ; Seong Sook HONG ; Jiyoung HWANG ; Boda NAM ; Sung Hwan BAE
Journal of the Korean Society of Radiology 2025;86(1):129-140
Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare Müllerian duct anomaly, commonly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. While these are the three most common genitourinary anomalies in OHVIRA syndrome, a spectrum of urogenital anomalies can be present. Knowledge of this spectrum is crucial for proper patient management and treatment planning. In this case series, we report on five patients with OHVIRA syndrome, each presenting with a urogenital anomaly other than the typical renal agenesis or uterus didelphys. We highlight the gynecological complications encountered, which clinicians and radiologists should be aware of.

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