Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
Am J Kidney Dis. 2011 Jan;57(1):175-8. doi: 10.1053/j.ajkd.2010.07.020.
Vascular complications after kidney biopsy include hematomas, arteriovenous fistulas, and pseudoaneurysms. Ultrasonography is a useful tool for the diagnosis of these complications, and color Doppler scan is effective at distinguishing among them. We describe a transplant patient who underwent percutaneous kidney biopsy in whom echography performed after biopsy showed a pulsatile hypoechoic perinephric mass of 4.4 cm. This collection illuminated with color Doppler and connected to the transplant. Color Doppler scanning of the mass showed high-velocity turbulent flow within the cavity and a jet of blood from an intrarenal segmental artery. A typical pattern biphasic flow ("to-and-fro" waveform) at the pseudoaneurysm neck on color Doppler confirmed the diagnosis of postbiopsy pseudoaneurysm. Pseudoaneurysms usually are asymptomatic, but when they cause clinical signs or risk rupture, interventional treatment is required. Supraselective coil embolization of the artery feeding the pseudoaneurysm was performed successfully in our patient. Pseudoaneurysm can mimic renal cysts on gray-scale ultrasound. We suggest that Doppler sonography be performed in cystic areas detected after biopsy to exclude pseudoaneurysm.
肾活检后的血管并发症包括血肿、动静脉瘘和假性动脉瘤。超声检查是诊断这些并发症的有用工具，彩色多普勒扫描可有效区分它们。我们描述了一位接受经皮肾活检的移植患者，活检后超声检查显示 4.4 厘米大小的搏动性低回声肾周肿块。该肿块在彩色多普勒下显示有高亮彩色血流，与移植肾相连。肿块的彩色多普勒扫描显示腔内高速湍流和来自肾段动脉的血流喷射。假性动脉瘤颈上典型的双相血流（“往返”波形）在彩色多普勒上证实了活检后假性动脉瘤的诊断。假性动脉瘤通常无症状，但当它们引起临床症状或有破裂风险时，需要介入治疗。我们对患者的假性动脉瘤供血动脉进行了超选择性线圈栓塞，治疗成功。假性动脉瘤在灰阶超声上可类似于肾囊肿。我们建议对活检后发现的囊性区域进行多普勒超声检查，以排除假性动脉瘤。
