DeVore G R
Genetics Institute, Pasadena, California, USA.
J Ultrasound Med. 1995 Jun;14(6):443-9. doi: 10.7863/jum.1995.14.6.443.
Real-time ultrasonographic diagnosis of renal agenesis may be difficult because of severe oligohydramnios. Recent reports have suggested that the absence of renal arteries on color Doppler ultrasonography may assist in the identification of renal agenesis. Because the position of the renal arteries is variable owing to fetal size, this study was undertaken to determine the location of the renal arteries as a function of fetal growth. Using color Doppler ultrasonography, 200 normal fetuses were studied in which the length of the aortic segment from the bifurcation of the iliac arteries to the renal arteries was measured. Regression analysis was performed in which the measured aortic segment was the dependent variable and the femur length the independent variable. Four cases of severe oligohydramnios were studied. The regression equation for the length of the aortic segment (Y) was significantly (P < 0.000001; R = 0.921) related to the femur length (X) (Yaortic segment (mm) = 3.1950 + 0.3034Xfemur length (mm); 99% prediction interval +/- 4.6 mm). In three cases of renal agenesis the renal arteries were not imaged with color Doppler sonography. Color Doppler imaging may be useful to identify the location of the renal arteries as they originate from the aorta. Using the data from this study, the location of the renal arteries can be determined for the corresponding femur length. If the renal arteries are not identified within the expected range (+/- 99% prediction interval) in fetuses in whom the kidneys are not identified with real-time ultrasonography, renal agenesis must be considered.
由于严重羊水过少，实时超声诊断肾缺如可能会很困难。最近的报告表明，彩色多普勒超声检查显示肾动脉缺失可能有助于识别肾缺如。由于肾动脉的位置因胎儿大小而异，因此进行本研究以确定肾动脉位置与胎儿生长的关系。使用彩色多普勒超声，对200例正常胎儿进行了研究，测量了从髂动脉分叉到肾动脉的主动脉段长度。进行回归分析，其中测量的主动脉段为因变量，股骨长度为自变量。对4例严重羊水过少的病例进行了研究。主动脉段长度（Y）的回归方程与股骨长度（X）显著相关（P < 0.000001；R = 0.921）（主动脉段长度（mm）= 3.1950 + 0.3034×股骨长度（mm）；99%预测区间±4.6 mm）。在3例肾缺如病例中，彩色多普勒超声未显示肾动脉。彩色多普勒成像可能有助于识别肾动脉起源于主动脉的位置。利用本研究的数据，可以根据相应的股骨长度确定肾动脉的位置。如果在实时超声未识别出肾脏的胎儿中，肾动脉不在预期范围内（±99%预测区间）被识别，则必须考虑肾缺如。
