同种异体移植肾的阻力指数：在常规临床环境中超声评估的可重复性是否足够？——肾阻力指数的可重复性

The Renal Resistive Index in Allografts: Is Sonographic Assessment Sufficiently Reproducible in a Routine Clinical Setting? - Reproducibility of the Renal Resistive Index.

作者信息

Theilig Dorothea Cornelia, Münzfeld Hanna, Auer Timo Alexander, Feldhaus Felix, Krüger Anne, Dürr Michael, Geisel Dominik

机构信息

Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, Germany.

Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Germany.

出版信息

Rofo. 2020 Jun;192(6):561-566. doi: 10.1055/a-1086-5191. Epub 2020 Feb 27.

DOI:10.1055/a-1086-5191

PMID:32106328

Abstract

PURPOSE

To assess the reproducibility of the renal resistive index (RRI) in a routine clinical setting.

MATERIALS AND METHODS

22 patients with a kidney allograft and 19 physicians participated in our prospective study. Within 2 hours each patient was examined by 5 different physicians using 2 out of 3 different, randomly allocated ultrasound machines. Each investigator determined the hilar and parenchymal RRI of the allograft. The reproducibility and reproducibility limit of the RRI were assessed as well as Cronbach's alpha and the intraclass correlation coefficient (ICC). The deviation of the RRI from the mean RRI over the 5 measurements was used as an indicator of reproducibility. The impact of the ultrasound machine, examiner's level of experience, and kidney function impairment (GFR < 45 ml/min) was assessed with the Kruskal-Wallis test. The bivariate linear correlation of the minimal transplant distance from the body surface with the variance of the parenchymal RRI was analyzed.

RESULTS

A reproducibility of 0.045 with a reproducibility limit of 0.124 was found for the parenchymal RRI. The ICC between RRIs was good with 0.852 for the parenchymal RRI and 0.868 for the hilar RRI. The type of ultrasound machine used was found to have a significant impact on the deviation of the parenchymal RRI (Kruskal-Wallis-Test, p = 0.003). Variance in serial parenchymal RRI measurements correlated significantly with the depth of the kidney transplant (p = 0.001).

CONCLUSION

While the RRI is generally sufficiently reproducible, the type of ultrasound machine used and the depth of the kidney transplant within the recipient's body have a significant impact on reproducibility.

KEY POINTS

· The renal resistive index (RRI) in allografts is reproducible.. · The type of ultrasound machine has an impact on the measured RRI.. · RRI reproducibility decreases with the depth of the renal allograft in the recipient..

CITATION FORMAT

· Theilig DC, Münzfeld H, Auer TA et al. The Renal Resistive Index in Allografts: Is Sonographic Assessment Sufficiently Reproducible in a Routine Clinical Setting?. Fortschr Röntgenstr 2020; 192: 561 - 566.

摘要

目的

评估肾阻力指数（RRI）在常规临床环境中的可重复性。

材料与方法

22例肾移植患者和19名医生参与了我们的前瞻性研究。在2小时内，由5名不同的医生使用3台不同的、随机分配的超声机器中的2台对每位患者进行检查。每位检查者测定移植肾的肾门和实质RRI。评估了RRI的可重复性和可重复性限度，以及克朗巴哈系数（Cronbach's alpha）和组内相关系数（ICC）。将RRI与5次测量的平均RRI的偏差用作可重复性的指标。使用Kruskal-Wallis检验评估超声机器类型、检查者的经验水平和肾功能损害（肾小球滤过率<45 ml/min）的影响。分析了移植肾距体表的最小距离与实质RRI方差的双变量线性相关性。

结果

实质RRI的可重复性为0.045，可重复性限度为0.124。RRI之间的ICC良好，实质RRI为0.852，肾门RRI为0.868。发现所使用的超声机器类型对实质RRI的偏差有显著影响（Kruskal-Wallis检验，p = 0.003）。实质RRI系列测量中的方差与肾移植深度显著相关（p = 0.001）。