Rifkin M D, Needleman L, Pasto M E, Kurtz A B, Foy P M, McGlynn E, Canino C, Baltarowich O H, Pennell R G, Goldberg B B
AJR Am J Roentgenol. 1987 Apr;148(4):759-62. doi: 10.2214/ajr.148.4.759.
The increasing use and availability of renal transplantation has resulted in a demand for noninvasive methods to study possible complications. One of the most serious adverse reactions is acute rejection, a possibly reversible cause of transplant failure if treated promptly. Differentiation from other causes of acute renal failure frequently is difficult, and the lack of specificity in many imaging studies has been troublesome. Eighty-one patients with renal transplants, including 41 with acute rejection, were examined. Duplex Doppler examination of the intrarenal arteries and a simplified formula, the resistive index ([peak systolic frequency shift--lowest diastolic frequency shift]/[peak systolic frequency shift]), were used to diagnose rejection. With a resistive index greater than 0.90, a 100% positive predictive value was obtained for the diagnosis of acute rejection. A value less than 0.70 was unlikely to be rejection (negative predictive value, 94%). This approach uses a simple analysis of the waveform. Use of a duplex Doppler examination and the formula described here appears to be an accurate method for the detection of acute rejection and for the differentiation of acute rejection from the various other causes of acute renal failure.
肾移植的日益普及和可及性使得人们对研究可能并发症的非侵入性方法有了需求。最严重的不良反应之一是急性排斥反应，如果及时治疗，这是移植失败的一个可能可逆的原因。与急性肾衰竭的其他病因进行区分常常很困难，而且许多影像学研究缺乏特异性一直是个难题。对81例肾移植患者进行了检查，其中包括41例急性排斥反应患者。使用肾内动脉的双功多普勒检查和一个简化公式——阻力指数（[收缩期峰值频移 - 舒张期最低频移]/[收缩期峰值频移]）来诊断排斥反应。阻力指数大于0.90时，急性排斥反应诊断的阳性预测值为100%。小于0.70的值不太可能是排斥反应（阴性预测值为94%）。这种方法对波形进行简单分析。使用双功多普勒检查和本文所述公式似乎是检测急性排斥反应以及将急性排斥反应与急性肾衰竭的各种其他病因进行区分的准确方法。
