Tomà P, Lucigrai G, Magnano G, Gusmano R, Piaggio G
Servizio di Radiologia, IRCCS Giannina Gaslini, Genova.
Radiol Med. 1994 Sep;88(3):244-8.
Ultrasonography is currently the method of choice to examine the pediatric patient because it is widely available, noninvasive and inexpensive. Particularly, Doppler US is the method of choice to study renal artery stenoses, which are among the most frequent causes of arterial hypertension in children, in both renal allografts and native kidneys. This study was aimed at investigating the value of the indirect signs of stenosis observed during the assessment of intrarenal vessels--i.e., changes in the waveform, resistive index and acceleration index. We examined 63 renal allograft recipients and a 12-year-old boy with a native kidney and arterial hypertension. In all cases the Doppler curves of the intrarenal vessels were studied both qualitatively and quantitatively. In this paper we report on 5 cases (4 allografts and 1 native kidney) with major waveform changes in the downstream renal circulation. Our findings confirmed the resistive index and the acceleration index measured with Doppler US in the intrarenal vessels to be major diagnostic tools in renal artery stenoses in the pediatric patient when the renal arteries are difficult to assess. However, the technique exhibits some limitations and allows an unquestionable diagnosis only in severe stenoses.
超声检查目前是检查儿科患者的首选方法，因为它广泛可用、无创且价格低廉。特别是，多普勒超声是研究肾动脉狭窄的首选方法，肾动脉狭窄是儿童动脉高血压最常见的原因之一，在肾移植和自体肾中均如此。本研究旨在调查在评估肾内血管期间观察到的狭窄间接征象的价值，即波形、阻力指数和加速度指数的变化。我们检查了63例肾移植受者以及一名患有自体肾和动脉高血压的12岁男孩。在所有病例中，均对肾内血管的多普勒曲线进行了定性和定量研究。在本文中，我们报告了5例（4例肾移植和1例自体肾）肾下游循环出现主要波形变化的病例。我们的研究结果证实，当肾动脉难以评估时，用多普勒超声测量肾内血管的阻力指数和加速度指数是儿科患者肾动脉狭窄的主要诊断工具。然而，该技术存在一些局限性，仅在严重狭窄时才能做出明确诊断。
