Granata Antonio, Floccari Fulvio, Lentini Paolo, Vittoria Salvatore, Di Pietro Fabio, Zamboli Pasquale, Fiorini Fulvio, Fatuzzo Pasquale
U.O.C. Nefrologia e Dialisi, Ospedale San Giovanni di Dio, Agrigento, Italy.
G Ital Nefrol. 2012 Nov-Dec;29 Suppl 57:S99-105.
The progressive decline in the incidence of graft rejection has made urological, surgical, parenchymal and vascular complications of kidney transplant more frequent. The latter, although accounting for only 5-10% of all post-transplant complications, are a frequent cause of graft loss. Ultrasonography, both in B-mode and with Doppler ultrasound, is an important diagnostic tool in case of clinical conditions which might impair kidney function. Even though ultrasonography is considered fundamental in the diagnosis of parenchymal and surgical complications of the transplanted kidney, its role is not fully understood in case of vascular complications of the graft. The specificity of Doppler ultrasound is very important in case of stenosis of the transplanted renal artery, pseudoaneurysms, arteriovenous fistulas, and thrombosis with complete or partial artery or vein occlusion. Doppler and color determinations present high diagnostic accuracy, which is higher in case of successive measurements performed during the follow-up of the graft. Modern techniques including contrast-enhanced ultrasound increase the diagnostic power of ultrasonography in case of vascular complications of the transplanted kidney, planted kidney.
移植肾排斥反应发生率的逐渐下降使得肾移植的泌尿外科、外科、实质和血管并发症更为常见。后者虽然仅占所有移植后并发症的5%-10%，却是移植肾丢失的常见原因。B超和多普勒超声检查是诊断可能损害肾功能的临床情况时的重要诊断工具。尽管超声检查被认为是诊断移植肾实质和外科并发症的基础，但在移植肾血管并发症的情况下，其作用尚未完全明确。对于移植肾动脉狭窄、假性动脉瘤、动静脉瘘以及动脉或静脉完全或部分闭塞的血栓形成，多普勒超声的特异性非常重要。多普勒和彩色测定具有很高的诊断准确性，在移植肾随访期间进行连续测量时诊断准确性更高。包括超声造影在内的现代技术提高了超声检查对移植肾血管并发症的诊断能力。
