Saarinen O, Salmela K, Edgren J
Division of Radiology, University Hospital, Helsinki, Finland.
Acta Radiol. 1994 Nov;35(6):586-9.
Doppler ultrasound (DU) with angiographic correlation was performed in 19 hypertensive renal transplant recipients suspected for transplant artery stenosis. DU included calculation of the intrarenal resistive index (RI) and measurement of the maximum systolic velocity in the transplant artery. All 10 cases having a pathologically low RI (< or = 0.6) had a > or = 50% stenosis; specificity and positive predictive values were thus 100%. There were 5 false-negative diagnoses, sensitivity 67%. The measurement of maximum systolic velocity was feasible in only 15 cases (79%). Using a cut-off point of 2 m/s the sensitivity was 91% and there were 4 false-positive cases and one false-negative case. Balloon percutaneous transluminal angioplasty (PTA) was performed in 13 cases, of which 9 were successful. In all successful cases RI was < 0.6 after PTA. We conclude that low RI (< 0.6) is highly suggestive for transplant artery stenosis. RI may serve as an indicator of the hemodynamic success of PTA.
对19例疑似移植肾动脉狭窄的高血压肾移植受者进行了与血管造影相关的多普勒超声（DU）检查。DU包括计算肾内阻力指数（RI）和测量移植肾动脉的最大收缩速度。所有10例病理RI值低（≤0.6）的病例均有≥50%的狭窄；因此特异性和阳性预测值均为100%。有5例假阴性诊断，敏感性为67%。仅15例（79%）可行最大收缩速度测量。采用2m/s的截断点时，敏感性为91%，有4例假阳性病例和1例假阴性病例。13例患者接受了经皮腔内球囊血管成形术（PTA），其中9例成功。在所有成功的病例中，PTA后RI均<0.6。我们得出结论，低RI（<0.6）高度提示移植肾动脉狭窄。RI可作为PTA血流动力学成功的指标。
