Saarinen O
Department of Radiology, Surgical Hospital, Helsinki University Central Hospital, Finland.
Acta Radiol. 1991 Mar;32(2):166-9.
Duplex ultrasonography was used in the diagnosis of acute rejection in 150 renal transplant recipients during the early post-transplant period. In 85 patients (56%) the allograft implantation had a stable postoperative course (control group) while 34 patients (23%) had no initial graft function due to acute tubular necrosis (ATN). Acute rejection occurred in 31 grafts (21%). Doppler spectra were obtained from the intrarenal arterial branches. An average resistive index (RI) was calculated from the spectra. The RI values of the control group differed significantly from those in both ATN and rejection groups. However, there was no statistical difference between the RI values of the ATN and rejection groups. Using a cutoff point of RI greater than or equal to 0.9 the sensitivity and specificity of the diagnosis of an acute rejection were 48.4 and 92.4 percent, respectively. All grafts with stable function had an RI less than 0.9. Thus, resistive index shows a poor sensitivity and a less than 100 percent specificity in the diagnosis of rejection. However, an RI greater than or equal to 0.9 is diagnostic of some kind of pathologic condition, including rejection and ATN.
在150例肾移植受者移植后的早期，采用双功超声检查诊断急性排斥反应。85例患者（56%）移植肾植入术后病情稳定（对照组），34例患者（23%）因急性肾小管坏死（ATN）最初无移植肾功能。31例移植肾（21%）发生急性排斥反应。从肾内动脉分支获取多普勒频谱。根据频谱计算平均阻力指数（RI）。对照组的RI值与ATN组和排斥反应组的RI值有显著差异。然而，ATN组和排斥反应组的RI值之间无统计学差异。以RI大于或等于0.9为界值，急性排斥反应诊断的敏感性和特异性分别为48.4%和92.4%。所有功能稳定的移植肾RI均小于0.9。因此，阻力指数在排斥反应诊断中敏感性较差，特异性低于100%。然而，RI大于或等于0.9可诊断某种病理状况，包括排斥反应和ATN。
