Perrella R R, Duerinckx A J, Tessler F N, Danovitch G M, Wilkinson A, Gonzalez S, Cohen A H, Grant E G
Department of Radiological Sciences, UCLA School of Medicine 90024.
Am J Kidney Dis. 1990 Jun;15(6):544-50. doi: 10.1016/s0272-6386(12)80524-5.
A disconcertingly wide variation exists in the literature as to the accuracy of duplex Doppler sonography in the detection of acute renal transplant rejection. Sensitivities range from 9% to 76%. In an attempt to explain the disparity of results, we undertook a double-blind prospective study of the accuracy of duplex Doppler ultrasound in the detection of acute rejection in renal transplants. We scanned 49 consecutive patients with a total of 65 biopsies; 46 biopsies in 33 consecutive patients were included in our study. In our population, the prevalence of acute rejection was 61% (28/46). Using a resistive index (RI) cutoff of greater than 0.90 based on the main renal artery flow pattern, the sensitivity of our test was 43%, with a 67% specificity. The positive predictive value was 67%. Our results are contrasted and compared with the published data from other groups in a critical survey of the literature. We conclude that duplex Doppler sonography alone is inadequate to evaluate acute rejection in renal transplants.
关于双功多普勒超声检查在检测急性肾移植排斥反应中的准确性，文献中存在令人不安的广泛差异。敏感性范围从9%到76%。为了解释结果的差异，我们对双功多普勒超声在检测肾移植急性排斥反应中的准确性进行了一项双盲前瞻性研究。我们对49例连续患者进行了总共65次活检；我们的研究纳入了33例连续患者的46次活检。在我们的研究人群中，急性排斥反应的发生率为61%（28/46）。根据肾主动脉血流模式，使用大于0.90的阻力指数（RI）临界值，我们的检测敏感性为43%，特异性为67%。阳性预测值为67%。在对文献的批判性综述中，我们将我们的结果与其他组发表的数据进行了对比和比较。我们得出结论，单纯的双功多普勒超声检查不足以评估肾移植中的急性排斥反应。
