Division of Internal Medicine, Nephrology, University of Colorado and Denver Veterans Affairs Medical Center, Denver, Colorado;, †Department of Radiology and, §Department of Internal Medicine and Pediatrics, Nephrology, University of Colorado Denver, Denver, Colorado, ‡Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
Clin J Am Soc Nephrol. 2014 Feb;9(2):382-94. doi: 10.2215/CJN.04840513. Epub 2013 Nov 14.
As judged by the American College of Radiology Appropriateness Criteria, renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation. Unfortunately, nephrologists are rarely specifically trained in ultrasonography technique and interpretation, and important clinical information obtained from renal ultrasonography may not be appreciated. In this review, the strengths and limitations of grayscale ultrasonography in the evaluation of patients with AKI will be discussed with attention to its use for (1) assessment of intrinsic causes of AKI, (2) distinguishing acute from chronic kidney diseases, and (3) detection of obstruction. The use of Doppler imaging and the resistive index in patients with AKI will be reviewed with attention to its use for (1) predicting the development of AKI, (2) predicting the prognosis of AKI, and (3) distinguishing prerenal azotemia from intrinsic AKI. Finally, pediatric considerations in the use of ultrasonography in AKI will be reviewed.
根据美国放射学院适宜性标准判断，肾脏多普勒超声检查是评估急性肾损伤（AKI）最适宜的影像学检查方法，具有最高的推荐级别。不幸的是，肾科医生很少接受专门的超声技术培训，而且可能无法重视从肾脏超声检查中获得的重要临床信息。在本次综述中，将讨论灰阶超声在评估 AKI 患者方面的优势和局限性，特别关注其在以下方面的应用：（1）评估 AKI 的内在病因；（2）区分急性和慢性肾脏病；（3）检测梗阻。将对多普勒成像和阻力指数在 AKI 患者中的应用进行综述，特别关注其在以下方面的应用：（1）预测 AKI 的发生；（2）预测 AKI 的预后；（3）区分肾前性氮质血症与内在 AKI。最后，将讨论在 AKI 中使用超声检查时的儿科注意事项。
