急性肾动脉血栓形成及栓塞的彩色多普勒超声诊断

目的 评价急性肾动脉血栓形成及栓塞的彩色多普勒超声表现及其临床意义。方法回顾性分析10例急性肾动脉血栓形成及栓塞患者的影像学检查结果，确诊依据为临床资料和影像学方法（8例），外科手术、病理（2例）。超声测量肾大小，观察肾内有无异常回声，观察肾内动、静脉血流信号的分布情况，测量肾内段或叶间动脉血流参数。结果 4例急性肾动脉血栓形成患者，均首先被超声正确提示后迅速采取了治疗措施，2例成功地进行了肾动脉插管溶栓治疗，2例超声显示肾动脉主干从部分阻塞至完全阻塞的发展过程。6例肾动脉栓塞患者，分别表现为楔形低回声伴血流信号缺失（2例），正常灰阶表现伴局部血流信号缺失（1例），局部血流信号分布稀疏（2例）和正常（1例）。结论 彩色多普勒超声可作为诊断急性肾动脉血栓形成及栓塞的首选影像学检查方法。

Diagnosis of acute renal artery thrombosis and embolism with color Doppler ultrasonography

Objective To evaluate color Doppler ultrasonography(CDU)appearances of acute renal artery thrombosis and embolism and its clinical value.Methods Ten patients with acute renal artery thrombosis and embolism were invoved,which were confirmed by the clinical data and imaging modalities findings(n=8)or by surgical and pathological results(n=2).The renal echogenicity and distribution of renal arterial and venous blood signals were observed,and the renal size and Doppler parameters from renal segmental or interlobar arteries were measured.Results Four patients with acute renal artery thrombosis were correctly indicated by CDU and then were treated in time,among which 2 underwent successfully thrombolytic treatment via the renal artery,and 2 displayed the changes in CDU appearances from partial to total occlusion of the main renal arteries.The CDU findings of the 6 kidneys with renal artery embolism were wedge hypoechoes with absence of blood signals(n=2),normal on gray scale imaging with absence of local blood signals(n=1),sparse blood signals in the area involved(n=2)and normal(n=1).Conclusions CDU can be used as the first screening modality in the diagnosis of acute renal artery thrombosis and embolism.The cases having typical CDU appearances can be diagnosed correctly and timely so that rapid and effective treatments can be taken.However,the cases having atypical CDU appearances should be performed further by enhanced CT or angiography.