Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, United States of America.
Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States of America.
Clin Imaging. 2021 Sep;77:142-146. doi: 10.1016/j.clinimag.2021.02.022. Epub 2021 Feb 26.
Compromise of the transplanted vasculature accompanying a kidney allograft can lead to graft failure if not diagnosed and treated expeditiously. Location of the vascular defect in the transplant renal artery or vein is difficult to anticipate, given the variety of etiologies. However, early diagnosis can anticipate further progression of kidney allograft dysfunction. Ferumoxytol-enhanced magnetic resonance angiography (FeMRA) can precisely localize lesions in both the transplant renal artery and vein and provide a comprehensive survey of the vascular conduits of concern. It avoids complications of kidney injury associated with intravenous iodinated contrast that may amplify a diagnosis of delayed graft function or further impair an allograft already compromised by donor-derived vascular disease.
We report a case of concomitant and irreversible proximal transplant renal artery and vein stenosis diagnosed by FeMRA and treated with surgical intervention.
FeMRA offers a rapid, non-invasive approach to simultaneously diagnose compromised blood flow through the transplant artery and or vein in preparation for definitive correction of the defect.
如果未能及时诊断和治疗，移植血管的损伤会导致移植肾失功。由于病因多样，移植肾动静脉血管损伤的位置难以预测。但是，早期诊断可以预测移植肾功能障碍的进一步进展。超顺磁性氧化铁增强磁共振血管造影（FeMRA）可以精确定位移植肾动静脉病变，并全面检查受累血管。它避免了静脉内碘对比剂引起的肾损伤并发症，这些并发症可能会放大诊断为移植肾功能延迟恢复或进一步损害已因供体血管疾病而受损的移植物。
我们报告了一例通过 FeMRA 诊断的同时发生且不可逆转的移植肾动静脉近段狭窄，并通过手术干预进行治疗。
FeMRA 提供了一种快速、非侵入性的方法，可以同时诊断移植肾动脉和（或）静脉血流受损，为明确纠正缺陷做准备。
