三维彩色多普勒超声监测移植肾的临床研究

目的　探讨三维彩色多普勒超声成像 ( 3D CDU)在移植肾术后监测中的图像特征及临床价值。　方法　应用彩色多普勒超声诊断仪和三维彩色多普勒图像处理工作站 ,采用磁场空间定位自由扫查系统对同种异体移植肾患者 34例进行三维图像获取 ,脱机后进行肾脏结构及血流的三维图像重建与显示。　结果　正常移植肾 3D CDU血流呈珊瑚状 ,立体分布于整个肾实质 ,信号均匀、对称、完整 ;发生急性肾小管坏死时移植肾血流信号明显稀疏 ;发生急性排异反应时移植肾血流信号呈斑块状或短棒状 ;血管栓塞时 ,栓塞血管的供血区域血流信号完全消失。 34例 3D CDU表现均与患者临床或病理结果吻合。　结论　三维彩色多普勒超声成像新技术具有信息量更丰富 ,动、静脉血流显示更完整、直观、立体感强且灵活多样等优点 ,是对二维超声成像的一种有意义的补充和完善。

Clinical study of three-dimensional color Doppler ultrasonography on monitoring transplanted kidney

Objective To discribe the characteristics of three-dimensional color Doppler ultrasonography (3D-CDU) and to evaluate the clinical value of 3D-CDU on monitoring transplanted kidney after surgery. Methods Thirty-four patients who underwent transplantation of allogeneic kidneys were examined with 3D-CDU.The involved instruments and techniques included color Doppler ultrasound diagnosis system and computer station of three-dimensional color Doppler ultrasonography.The way of acquiring images was magnetic positioning free-hand scanning.Three-dimensional reconstruction and display of renal tissue structure and blood flow were performed off-line. Results The 3D-CDU showed that the vasculature of normal transplanted kidney was distributed among entire renal parenchyma in the form of coral,and the color flow signals were uniform,symmetry and complete.When acute rejection or acute necrosis of renal tubules occurred,the distribution of renal blood flow signals became obviously sparse in the three-dimensional color Doppler images.In the case of vascular embolism,color flow signals of the renal region,which was provided with blood by the embolized renal artery,disappeared completely. Conclusions The 3D-CDU has some superiorities of containing more information,more stereoscopic effect,more comprehensive and flexible ways of observation.The 3D-CDU can replenish and improve two-dimensional ultrasonography,whereby it is helpful to improve diagnosis level of ultrasonography on monitoring transplanted kidney.