彩色多普勒超声诊断早期移植肾急性排斥

目的探讨彩色多普勒超声图像数据分析在诊断早期移植肾急性排斥中的作用及临床价值.方法总结203例肾移植术后6～30d内行彩色多普勒超声检查,结合临床症状、生化检查并参照病理诊断,对二维灰阶图像、彩色血流图、血流频谱及阻力指数(RI)、搏动指数(PI)、收缩期与舒张期血流速度比(S/D)等参数进行回顾性分析.结果以彩色多普勒RI>0.78、PI>1.82、S/D>4.1为标准,结合彩色血流图及血流频谱形态,早期移植肾急性排斥正确诊断率可达85.7%.结论应用彩色多普勒超声诊断移植肾早期急性排斥并监测其功能恢复,具有快速、准确、无创等优点,可提早发现病情变化并指导治疗,提高移植肾存活率.

Color Doppler sonography in the diagnosis of early stage of acute re n al allograft rejection

Objective To evaluate color Doppler sonography in the diagnosis of early stage of acute renal allograft rejection. Methods Real time color Doppler image of renal allografts of 203 patients taken on the 6th to 30th postoperative days were reviewed together with two dimention grey scale picture,color picture of blood flowing, spectrogram,RI(resistance index), PI(pulse index), S/D (the ratio of blood flowing velocity of systole period and diastole period )and clinic symptoms, as correlated to the findings of renal biopsy and fine needle aspiration cytology. Results 107 cases were diagnosed as early stage of acute renal allografts rejection. 99 renal allografts(92.5%) resumed normal function after specific therapies.The first findings on the diagnosis of early stage of acute renal allograft rejection were RI>0.78, PI>1.82, S/D>4.1, the second were color picture of blood flowing and spectrogram. Correspondingly, the correct rate of clinical diagnosis were 85.7%.Raised RI.PI and S/D were significantly valuable in the diagnosis of the early stage of acute renal allograft rejection,the sensitivity being 85.1%,86.9%,80.2% respectively and the specificity 87.6%,89.2%,84.3%. Conclusions Color Doppler findings and the above mentioned parameters are valuable for detection of early stage of acute renal allograft rejection,providing a fast, accurate, non invasive technique for predicting the renal allograft rej ection and guiding suitable clinical therapies in time.Moreover,renal biopsy may be avoided.Thus,fear of the patient for the procedure and complications of the renal biopsy are banished raising the survival rate of the allograft.