高频超声及多普勒能量图在移植肾中的诊断价值

Renal Transplant Evaluation with High Frequency Ultrasound and Power Doppler Sonography

应用高频超声和多普勒能量图(PDS)对20例正常移植肾、18例急性排异(AR)、8例急性肾小管坏死(ATN)、16例慢性移植功能障碍(CGD)患者进行研究.结果显示:用高频二维超声有助于诊断AR、ATN、CGD.移植肾皮质部的PDS显像分级能较好地评价皮质部血流灌注,但AR、ATN及CGD也可呈正常分级,PDS的诊断敏感性不如RI值.皮质部RI值随检测部位不同而有差异,以CGD最为明显.移植肾皮质部血流灌注不良时,血流充盈缺乏首先发生在等容收缩期.用高频PDS超声和肾皮质部多点检测RI值,可较好地评价移植肾功能障碍.

In this study, we scanned 62 renal transplants: 20 normal, 18 acute rejection(AR), 8 acute tubular nec.rosis(ATN), 16 chronic graft dysfunction(CGD). It showed that two-dimentional high frequency ultrasound is useful for diagnosis AR, ATN and CGD. The graduated image of cortex can evaluate blood flow perfusing of cortex well. But AR、 ATN and CGD also show normal grade image. So the sensitivity of power doppler sonography is less than that of RI. The RI of cortex is different at various region, especialy in CGD. The inadiquate perfusing of cortex appeared first at isovolumetric systole. Using high frequency ultrasound and power doppler sonography, obtaining mean RI from several sample site. We can evaluate transplant kidney dysfunction well.