Petrek J, Tilney N L, Smith E H, Williams J S, Vineyard G C
Ann Surg. 1977 Apr;185(4):441-7. doi: 10.1097/00000658-197704000-00012.
Because of important differences in prognosis and treatment, prompt and accurate diagnosis of fever, decreasing function, and pain and tenderness around a renal allograft is crucial for differentiation between acute rejection and other post-operative conditions which may give a similar picture. Ultrasound examinations within 24 hours have been performed on all transplant recipients exhibiting symtoms compatible on all transplant recipients exhibiting symptoms compatible with an episode of acute rejection between September 1973 and June 1976 at the Peter Bent Brigham Hospital. The patients were separated into four groups dependent upon diagnosis by ultrasound; Group I(73 patients); allograft enlargment consistent with acute rejection; Group II (14 patients); dilitation of the collecting system; Group III (14 patients); perinephric fluid collections; Group IV (6 patients); miscellaneous conditions. The accuracy of the ultrasound technique was compared within each group to the results from intravenous pyelography, retrograde pyelography, serial renograms, kidney biopsy and/or surgical exploration. This convenient, non-invasive and reproducible method has been extremely effective in the differential diagnosis of rejection in clinical transplantation.
由于在预后和治疗方面存在重要差异，对于同种异体肾移植周围出现的发热、功能减退以及疼痛和压痛，迅速且准确的诊断对于区分急性排斥反应和其他可能呈现类似症状的术后情况至关重要。1973年9月至1976年6月期间，在彼得·本特·布里格姆医院，对所有出现与急性排斥反应发作相符症状的移植受者在24小时内进行了超声检查。根据超声诊断，患者被分为四组：第一组（73例患者），移植肾增大符合急性排斥反应；第二组（14例患者），集合系统扩张；第三组（14例患者），肾周液体积聚；第四组（6例患者），其他情况。将每组中超声技术的准确性与静脉肾盂造影、逆行肾盂造影、系列肾图、肾活检和/或手术探查的结果进行了比较。这种便捷、无创且可重复的方法在临床移植中对排斥反应的鉴别诊断极为有效。
