Briscoe D M, Hoffer F A, Tu N, Harmon W E
Department of Medicine, Children's Hospital, Boston, MA 02115.
Pediatr Radiol. 1993;23(5):365-8. doi: 10.1007/BF02011960.
We reviewed the diastolic blood flow (DBF), pulsatility index (PI), and resistive index (RI) in 211 duplex Doppler ultrasound examinations of 63 pediatric renal transplant recipients. We correlated our findings with the clinical diagnosis, independently determined at the time of ultrasound examination. DBF, evaluated in 202 examinations, was found to be decreased, absent, or reversed in acute rejection (kappa = 0.4, p < 0.01) and acute tubular necrosis (ATN) (kappa = 0.3, p < 0.01). The PI and RI were evaluated in 87 and 78 ultrasound examinations respectively. The range of normal PI and RI values in recipients between six and 18 years of age were similar to those reported in adults. However, normal PI and RI values were somewhat higher in recipients less than six years of age who had received adult donor allografts. Overall, the PI was greater than 1.5 in acute rejection (kappa = 0.3, p < 0.05) and ATN (kappa = 0.3, p < 0.01), but not in chronic rejection (kappa < 0, p = NS). The RI was greater than 0.7 in chronic rejection (kappa = 0.3, p < 0.05) and ATN (kappa = 0.3, p < 0.05), but not in acute rejection (kappa = 0.03, p = NS). We conclude that the PI and RI vary in pediatric recipients of renal allografts and are not associated with a specific clinical diagnosis.
我们回顾了63例小儿肾移植受者的211次双功多普勒超声检查中的舒张期血流（DBF）、搏动指数（PI）和阻力指数（RI）。我们将研究结果与超声检查时独立确定的临床诊断进行了关联。在202次检查中评估的DBF在急性排斥反应（kappa = 0.4，p < 0.01）和急性肾小管坏死（ATN）（kappa = 0.3，p < 0.01）中发现降低、消失或反向。PI和RI分别在87次和78次超声检查中进行了评估。6至18岁受者的正常PI和RI值范围与成人报道的相似。然而，接受成人供体同种异体移植的6岁以下受者的正常PI和RI值略高。总体而言，急性排斥反应（kappa = 0.3，p < 0.05）和ATN（kappa = 0.3，p < 0.01）中PI大于1.5，但慢性排斥反应中并非如此（kappa < 0，p =无统计学意义）。慢性排斥反应（kappa = 0.3，p < 0.05）和ATN（kappa = 0.3，p < 0.05）中RI大于0.7，但急性排斥反应中并非如此（kappa = 0.03，p =无统计学意义）。我们得出结论，PI和RI在小儿肾移植受者中有所不同，且与特定的临床诊断无关。
