Barrientos A, Leiva O, Diaz-Gonzalez R, Polo G, Ruilope L M, Alcazar J M, Rodicio J L, Borobia V, Navas J
J Urol. 1981 Sep;126(3):308-12. doi: 10.1016/s0022-5347(17)54498-5.
In 43 renal transplant patients studied by ultrasonography there were 32 episodes of acute rejection and 17 of acute tubular necrosis. The size of the kidney increased in all cases. However, in 75 per cent of the patients with acute rejection the central echoes of the renal sinus increased conspicuously, while in 77 per cent of those with acute tubular necrosis the echogenicity of the central sinusal complex decreased. These findings may be expressions of different pathological lesions at the renal sinus level in patients with acute rejection and acute tubular necrosis, which would modify the acoustic interphase. Therefore, we have found panniculitis, vasculitis, thrombosis and inflammatory cellular infiltration of the urinary collecting systems to be significant in patients with acute rejection but not in those with acute tubular necrosis. Ultrasonography can be an adjuvant instrument for the sometimes difficult differential diagnosis between acute tubular necrosis and acute rejection immediately after transplantation, and also for the diagnosis of acute rejection whenever it appears.
在通过超声检查研究的43例肾移植患者中，有32次急性排斥反应发作和17次急性肾小管坏死发作。所有病例中肾脏大小均增加。然而，75% 的急性排斥反应患者肾窦的中央回声明显增强，而77% 的急性肾小管坏死患者中央窦复合体的回声性降低。这些发现可能是急性排斥反应和急性肾小管坏死患者肾窦水平不同病理病变的表现，这会改变声学界面。因此，我们发现脂膜炎、血管炎、血栓形成和泌尿收集系统的炎性细胞浸润在急性排斥反应患者中显著，但在急性肾小管坏死患者中不显著。超声检查可以作为一种辅助手段，用于移植后急性肾小管坏死和急性排斥反应有时难以鉴别的诊断，也可用于急性排斥反应出现时的诊断。
