彩色多普勒超声评价血流参数指标在诊断移植肾动脉狭窄中的价值

The Application of Color Doppler Flow Imaging Parameters in Diagnosis Transplant Renal Artery Stenosis

目的:探讨彩色多普勒超声显像对肾移植术后动脉并发症的诊断价值。方法:应用彩色多普勒技术(CDFI)发现了20例发生移植肾动脉狭窄患者,并接受了动脉造影检查,证实有移植肾动脉狭窄,其中2例为重度狭窄导致闭塞。20例患者测量5项多普勒血流参数,肾动脉主干、叶间动脉收缩期峰值流速、加速时间和阻力指数,并进行对比分析。结果:移植肾动脉血管造影显示,13例狭窄部位发生在吻合口附近,5例发生在肾动脉主干,2例移植肾动脉闭塞。移植肾动脉收缩期最大血流速度(PSV)≥2.0 m/s,小叶间动脉加速时间(AT)延长≥0.10 s,阻力指数<0.07,敏感性分别为100%,90%,54%。2例移植肾动脉闭塞无或稀少血流信号。结论:移植肾动脉吻合口及肾动脉主干收缩期最大血流速度(PSV),小叶间加速时间(AT)在诊断移植肾动脉狭窄上敏感性较高;彩超显示移植肾内部血流信号消失或肾内仅显示稀少血流信号是移植肾动脉闭塞重要的诊断依据。

Objective：To investigate ultrasonic diagnosis of artery complication in transplant renal.Methods：a study group of twenty patients were referred to DSA and confirmed to have a TRAS,two patients were confirmed to transplant renal occlusion.Five Doppler parameters,including the peak systolic velocity（PSV）in the renal artery,iliac artery,acceleration time,resistance index were measured.Results： of the twenty patients,DSA demonstrated 13 cases in the entrance of the renal artery,5 cases main renal arteries with severe stenosis.two cases were confirmed to transplant renal occlusion.CDFI shows renal arteries PSV ≥2.0 m/s,acceleration time ≥0.10 s,resistance index 0.70,The sensitivities were 100%,90%,54%.2 patients were diagnosed as transplant renal occlusion,1 case was completely blocked in the renal artery and vein.Which were disappear blood flow signal in the internal transplant renal.the other 1 case was partly blocked,there were one tiny artery blood flow signal in the internal transplant renal.Conclusion：It was high specificity that we observed the peak systolic velocity to heighten and accelerate time to delay.It was important evidence in the diagnosis transplant renal artery occlusion that we detected no or rare blood flow signal by Color Doppler Flow Imaging.