彩色多普勒超声诊断移植肾动脉狭窄的临床应用价值  

Clinical application of color doppler flow imaging for diagnosis of transplant renal artery stenosis

作　　者：王旭珍[1] 薛武军[1] 丁小明[1] 项和立[1] 李杨[1] 丁晨光[1] 焦李子[1] 

机构地区：[1]西安交通大学第一附属医院肾移植科,710061

出　　处：《中华器官移植杂志》2016年第9期537-540,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81670682、81400677）;陕西省科学技术研究发展计划（2014KW2003）

摘　　要：目的探讨彩色多普勒超声在肾移植后肾动脉狭窄诊断中的临床应用价值。方法对2015年9月至2016年7月间收治的216例肾移植后受者进行常规彩色多普勒随访监测，通过测肾动脉、肾段动脉及叶间动脉收缩期峰值流速、阻力指数，并进行对比分析，拟诊移植肾动脉狭窄。所有拟诊患者均行移植肾动脉造影确定诊断。结果14例拟诊移植肾动脉狭窄的患者全部接受移植肾动脉造影检查，确诊12例，超声诊断准确率为85．7％。当肾动脉PSV／叶间动脉PSV〉10，即峰值流速后比〉10时，诊断TRAS的敏感度和特异度最高，分别为91％和95％。血管介入治疗后7d肾段动脉及叶间动脉峰值流速明显增加，肾动脉血流速度降低。结论彩色多普勒操作简便、无创、准确度高，可作为筛查移植肾动脉狭窄及血管介入治疗效果评价的首选方法。移植肾动脉PSV／叶间动脉PSV（峰值流速后比）用于诊断移植肾动脉狭窄敏感度及特异度较高。Objective To investigate the clinical value of color Doppler flow imaging （CDFI） for evaluating transplant renal artery stenosis （TRAS）. Methods Clinical and ultrasonographic data of 216 kidney transplant recipients were collected by follow-up monitoring from September 2015 to July 2016. CDFI indexes included the peak systolic velocity （PSV） in the renal artery and resistant index （RI）. Renal artery PSV and RI were measured. All suspected TRAS patients accepted transplant renal artery angiography （DSA）. Results Fourteen patients with suspected TRAS accepted DSA, of which 12 patients were confirmed. The diagnostic accuracy of CDFI was 85.7%. When the POST- PSV ratio〉 10, the sensitivity and specificity of diagnosis of TRAS were 91% and 95%, respectively. CDFI indexes remarkably changed after the TRAS patients had undergone renal artery dilatation or stent implantation. PSV of the main renal artery and the POST-PSV ratio decreased significantly, and the PSV of interlobar arteries increased. Conclusions CDFI is a reliable first choice for screening transplant renal artery stenosis. The POST-PSV ratio has relatively higher sensitivity and specificity in the diagnosis of TRAS.

关 键 词：超声检查 多普勒 彩色 肾移植 肾动脉 狭窄 手术后并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]