张云飞,王学梅,欧国成,阙艳红,孟一曼,李弘.彩色多普勒超声鉴别诊断肾移植急性排斥反应与急性肾小管坏死[J].中国医学影像技术,2010,26(10):1923~1925
彩色多普勒超声鉴别诊断肾移植急性排斥反应与急性肾小管坏死
Color Doppler ultrasound in differentiation of acute rejection and acute tubular necrosis following renal transplantation
投稿时间:2010-01-16  修订日期:2010-07-28
DOI:
中文关键词:  肾移植  超声检查,多普勒,彩色  移植物排斥  肾小管坏死,急性
英文关键词:Kidney transplantation  Ultrasonography, Doppler, color  Graft rejection  Kidney tubular necrosis, acute
基金项目:辽宁省教育厅2006—2007年度高等学校科研项目(20060970)。
作者单位E-mail
张云飞 中国医科大学附属第一医院超声诊断科,  
王学梅 中国医科大学附属第一医院超声诊断科, wxmlmt@yahoo.com.cn 
欧国成 中国医科大学附属第一医院超声诊断科,  
阙艳红 中国医科大学附属第一医院超声诊断科,  
孟一曼 普通外科教研室器官移植科,辽宁 沈阳 110001  
李弘 普通外科教研室器官移植科,辽宁 沈阳 110001  
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中文摘要:
       目的 探讨彩色多普勒超声对肾移植急性排斥反应(AR)与急性肾小管坏死(ATN)的鉴别诊断意义。方法 对27例AR患者(AR组)及13例ATN患者(ATN组)行序列超声检查,常规测量移植肾大小,观察血流显示率,测量肾段动脉及肾门部动脉阻力指数(RI)。记录术后首次RI≥0.70的时间及AR患者术后血肌酐(Cr)突然升高的时间,计算移植肾体积增大的百分比。结果 AR与ATN组肾段动脉RI分别为0.76±0.11、0.78±0.05(P>0.05),肾门部动脉RI分别为0.81±0.09、0.83±0.06(P>0.05),血流显示率<4级者分别占33.33%、30.77%(P>0.05),移植肾体积增大>30%者分别占77.78%、38.46%(P<0.05),术后首次RI≥0.70发生的时间≥10天者分别占77.78%、23.08%(P<0.05)。结论 移植肾动脉RI、血流显示率对AR与ATN无鉴别诊断意义,移植肾体积增大的百分比、术后首次RI≥0.70发生的时间对AR与ATN有鉴别诊断意义。
英文摘要:
      Objective To estimate the value of color Doppler ultrasound in differentiation of acute rejection (AR) and acute tubular necrosis (ATN) following renal transplantation. Methods Twenty-seven patients with AR (AR group)and 13 patients with ATN (ATN group) underwent color Doppler ultrasonography. Records were made in volume enlargement, color Doppler flow image (CDFI), resistance index (RI) of renal arteries. The date when RI firstly ≥0.70 and Cr increased obviously was recorded as well. Results RI of renal segmental arteries was 0.76±0.11 in AR group and 0.78±0.05 in ATN group (P>0.05). RI of hilar renal arteries was 0.81±0.09 in AR group and 0.83±0.06 in ATN group (P>0.05). Blood flow signal in arteries less than grade 4 was displayed in 33.33% patients with AR and 30.77% patients with ATN (P>0.05). Kidney volume enlarged with a growth rate of over 30% in 77.78% patients with AR and 38.46% patients with ATN (P<0.05). RI≥0.70 firstly occurred on the tenth day or over it, occupying 77.78% in AR group and 23.08% in ATN group (P<0.05). Conclusion The volume enlargement and the date when RI≥0.70 are valuable in differentiation of AR and ATN, while CDFI and RI are not.
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