Mizrahi S, Hussey J L, Hayes D H, Boudreaux J P, Merritt C R, Bluth E I
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
South Med J. 1993 Oct;86(10):1126-8. doi: 10.1097/00007611-199310000-00009.
Doppler color flow imaging has been used to identify obstruction, rejection, and nonfunctioning renal allografts. When done in the immediate posttransplant period on poorly functioning kidneys, it allows early and accurate detection of surgically correctable changes such as arterial or venous thrombosis or early obstruction by blood, urine, or lymph. Further, it determines changes in intrarenal flow patterns that may indicate early transplant dysfunction, such as acute tubular necrosis and/or acute rejection as well as obstruction. Additionally, baseline values can be obtained in uncomplicated cases for serial follow-up. Between July 1980 and February 1991, 20 transplant patients had Doppler color flow imaging in the immediate posttransplant period. The kidney contour, perirenal collections, vessel flow patterns, and resistive indexes were assessed. In two patients, immediate surgical intervention salvaged the allograft. In several other patients with primary nonfunctioning kidneys, the study distinguished between acute tubular necrosis and obstruction due to external compression. We concluded that protocol Doppler color flow imaging is valuable in the immediate posttransplant period for determining surgically correctable complications.
多普勒彩色血流成像已被用于识别肾移植受者的移植肾梗阻、排斥反应和无功能状态。在移植后早期对功能不良的移植肾进行检查时，它能够早期、准确地检测出可通过手术纠正的变化，如动脉或静脉血栓形成，或血液、尿液或淋巴液导致的早期梗阻。此外，它还能确定肾内血流模式的变化，这些变化可能提示早期移植肾功能障碍，如急性肾小管坏死和/或急性排斥反应以及梗阻。另外，对于无并发症的病例，可以获取基线值以便进行系列随访。在1980年7月至1991年2月期间，20例移植患者在移植后早期接受了多普勒彩色血流成像检查。评估了肾脏轮廓、肾周积液、血管血流模式和阻力指数。在2例患者中，及时的手术干预挽救了移植肾。在其他几例原发性无功能肾的患者中，该检查区分了急性肾小管坏死和外部压迫导致的梗阻。我们得出结论，常规多普勒彩色血流成像在移植后早期对于确定可通过手术纠正的并发症具有重要价值。
