Galanski M, Friedmann G
Rontgenblatter. 1976 Oct;29(10):483-9.
Comparison of angiographic, clinical and bioptic findings after kidney transplantation permits the following statements: Angiography is indicated with the appearance of a hypertony after transplantation and in clinically unclear reduction of function; it is the method of choice for proof or exclusion of a vascular complication. Recognizable vascular alterations and an extended arterial wash-out time during previous crises tend to indicate severe damage which affects the whole organ. On the other hand, the same alterations in chronic rejection do not permit a conclusive evaluation of the ability of the transplant to function. Isolated cortical ischemia in regard to rejection occurs relatively early and is prognostically an unfavourable sign. Differentiation of low grade rejection: tubular necrosis is hardly possible on the basis of the angiogram. As a result, the value of angiography for the diagnosis of rejection in the clinically important, but less pronounced, stages is limited. The most important of the informative diagnostic measures is renal sequence scintigraphy. This technique not only makes an early diagnosis possible but also an observation of the course of the reaction.
肾移植后血管造影、临床及活检结果的比较可得出以下结论：移植后出现高血压以及临床功能减退原因不明时，需进行血管造影；它是证实或排除血管并发症的首选方法。先前发作时可识别的血管改变及动脉洗脱时间延长往往提示影响整个器官的严重损伤。另一方面，慢性排斥反应中的相同改变无法对移植器官的功能能力进行确定性评估。与排斥反应相关的孤立性皮质缺血相对较早出现，且预后不良。低度排斥反应的鉴别：基于血管造影几乎无法区分肾小管坏死。因此，血管造影在临床上重要但不太明显的排斥反应诊断阶段的价值有限。最重要的信息性诊断措施是肾序列闪烁扫描。该技术不仅能实现早期诊断，还能观察反应过程。
