Platt J F, Rubin J M, Ellis J H
Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-0030.
Radiology. 1993 Mar;186(3):685-8. doi: 10.1148/radiology.186.3.8430174.
To evaluate duplex Doppler ultrasound (US) in acute renal obstruction, bilateral intrarenal Doppler US was performed in 23 patients with unilateral renal obstruction (proved by means of intravenous urography) of 36 hours duration or less. A mean renal resistive index (RI) was calculated for each obstructed and normal contralateral kidney and compared with findings on conventional US scans. The mean RI in the obstructed kidneys was elevated (.77 +/- .07 [standard deviation]) and was higher than the mean RI in the normal contralateral kidney (.60 +/- .04) (P < .001). RIs in the obstructed kidneys were as follows: .75 or greater in 15 kidneys, .70-.74 (mild RI elevation) in five kidneys (but > or = .10 higher than the RI in the normal contralateral kidney), and less than .70 in three kidneys (two of these three patients had pyelosinus extravasation and one patient had clinical obstruction for only 4-5 hours). RI elevation occurred before collecting-system dilatation in four patients (17%). RI elevation occurs by 6 hours of clinical acute renal obstruction and may precede pyelocaliectasis. Renal duplex Doppler US contributes useful clinical information, especially when US is the first modality used to evaluate acute renal colic.
为评估双功多普勒超声（US）在急性肾梗阻中的应用，对23例单侧肾梗阻（经静脉肾盂造影证实）且病程在36小时及以内的患者进行了双侧肾内多普勒超声检查。计算每个梗阻肾和对侧正常肾的平均肾阻力指数（RI），并与传统超声扫描结果进行比较。梗阻肾的平均RI升高（0.77±0.07[标准差]），高于对侧正常肾的平均RI（0.60±0.04）（P<0.001）。梗阻肾的RI情况如下：15个肾的RI为0.75或更高，5个肾的RI为0.70 - 0.74（轻度RI升高）（但比正常对侧肾的RI高≥0.10），3个肾的RI小于0.70（这3例患者中有2例存在肾盂窦外渗，1例患者临床梗阻仅4 - 5小时）。4例患者（17%）在集合系统扩张之前出现RI升高。临床急性肾梗阻6小时时出现RI升高，且可能先于肾盂肾盏扩张。肾双功多普勒超声可提供有用的临床信息，尤其是当超声是用于评估急性肾绞痛的首选检查方法时。
