Brown E D, Chen M Y, Wolfman N T, Ott D J, Watson N E
Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1088, USA.
Radiographics. 2000 May-Jun;20(3):607-22. doi: 10.1148/radiographics.20.3.g00ma14607.
Following renal transplantation, patients are often evaluated with ultrasonography (US) or radionuclide imaging to assess renal function and the presence of possible complications. Both modalities are inexpensive, noninvasive, and nonnephrotoxic. A basic understanding of the surgical techniques commonly used for renal transplantation is useful when imaging these patients in order to recognize complications and to direct further imaging or intervention. The most frequent complications of renal transplantation include perinephric fluid collections; decreased renal function; and abnormalities of the vasculature, collecting system, and renal parenchyma. Perinephric fluid collections are common following transplantation, and their clinical significance depends on the type, location, size, and growth of the fluid collection, features that are well-evaluated with US. Causes of diminished renal function include acute tubular necrosis, rejection, and toxicity from medications. Radionuclide imaging is the most useful modality for assessing renal function. Vascular complications of transplantation include occlusion or stenosis of the arterial or venous supply, arteriovenous fistulas, and pseudoaneurysms. Although the standard for evaluating these vascular complications is angiography, US is an excellent noninvasive method for screening. Other transplant complications such as abnormalities of the collecting system and renal parenchyma are well-evaluated with both radionuclide imaging and US.
肾移植后，患者常接受超声检查（US）或放射性核素成像，以评估肾功能及是否存在可能的并发症。这两种检查方法都价格低廉、无创且无肾毒性。在对这些患者进行成像检查时，对肾移植常用手术技术有基本了解，有助于识别并发症并指导进一步的成像检查或干预。肾移植最常见的并发症包括肾周积液、肾功能减退以及血管、集合系统和肾实质异常。肾周积液在移植后很常见，其临床意义取决于积液的类型、位置、大小和生长情况，这些特征通过超声检查能得到很好的评估。肾功能减退的原因包括急性肾小管坏死、排斥反应和药物毒性。放射性核素成像在评估肾功能方面是最有用的检查方法。移植的血管并发症包括动脉或静脉供应的阻塞或狭窄、动静脉瘘和假性动脉瘤。虽然评估这些血管并发症的标准是血管造影，但超声是一种出色的无创筛查方法。其他移植并发症，如集合系统和肾实质异常，通过放射性核素成像和超声检查都能得到很好的评估。
