Gao Jing, Rubin Jonathan M, Xiang Dong-ying, He Wen, Auh Yong Ho, Wang John, Ng Amelia, Min Robert
Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10065 USA.
J Ultrasound Med. 2011 Feb;30(2):169-75. doi: 10.7863/jum.2011.30.2.169.
The aim of this study was to assess the relationship between intrarenal Doppler parameters and histopathologic changes shown on kidney biopsy in renal transplant dysfunction.
We retrospectively reviewed the records of 113 patients (61 men and 52 women; age range, 22-76 years; mean age ± SD, 50.9 ± 12.7 years) who underwent both transplanted kidney sonography and biopsy from May 1, 2007, to May 31, 2009. Doppler parameters of the interlobar arteries, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were compared with kidney biopsy findings. According to histopathologic findings, the 113 patients were divided into two groups: 1, interstitial fibrosis/tubular atrophy and vascular/glomerular sclerosis (n = 79); and 2, edematous changes in glomeruli without fibrosis (n = 34). The correlations between Doppler parameters and histopathologic findings were statistically analyzed.
There were statistically significant differences in the PSV and EDV of the interlobar arteries between groups 1 and 2. Both the PSV and EDV in group 1 were significantly lower than those in group 2 (P < .001). There was no significant difference in the RI of the interlobar arteries between the two groups (P > .05). There were no significant differences in the PSV, EDV, and RI of the main renal artery between the two groups (all P > .05).
The PSV and EDV of the interlobar artery have statistical correlations with histopathologic types in renal transplant dysfunction. Both the PSV and EDV in interstitial fibrosis/tubular atrophy and vascular/glomerular sclerosis seem lower than those in glomerulopathy without fibrosis. Hence, the PSV and EDV of the interlobar artery may potentially be used as hemodynamic indicators for monitoring the progress of renal transplants.
本研究旨在评估肾移植功能障碍时肾内多普勒参数与肾活检显示的组织病理学变化之间的关系。
我们回顾性分析了2007年5月1日至2009年5月31日期间113例患者（61例男性和52例女性；年龄范围22 - 76岁；平均年龄±标准差，50.9±12.7岁）的记录，这些患者均接受了移植肾超声检查和活检。将叶间动脉的多普勒参数，包括收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）与肾活检结果进行比较。根据组织病理学结果，将113例患者分为两组：1. 间质纤维化/肾小管萎缩和血管/肾小球硬化组（n = 79）；2. 无纤维化的肾小球水肿改变组（n = 34）。对多普勒参数与组织病理学结果之间的相关性进行统计学分析。
1组和2组叶间动脉的PSV和EDV存在统计学显著差异。1组的PSV和EDV均显著低于2组（P <.001）。两组叶间动脉的RI无显著差异（P>.05）。两组主肾动脉的PSV、EDV和RI均无显著差异（所有P>.05）。
肾移植功能障碍时，叶间动脉的PSV和EDV与组织病理学类型存在统计学相关性。间质纤维化/肾小管萎缩和血管/肾小球硬化组的PSV和EDV似乎低于无纤维化的肾小球病组。因此，叶间动脉的PSV和EDV可能作为监测肾移植进展的血流动力学指标。
