Miralles Hernández M, Bestard Palmer J, Gascó Company J, Lozano Vilardell P, Corominas Roura C, Blanes Mompó I, Cairols Castellote M
Hospital del Mar, Barcelona, Palma de Mallorca, España.
Arch Esp Urol. 1995 Dec;48(10):1001-8.
To determine the utility of renal duplex sonography in the detection of vascular complications in renal grafts.
45 patients with a median post-transplant follow-up of 39.3 +/- 28.8 months were evaluated. The renal artery maximum systolic velocity (SVmax) and the renal artery/iliac artery Svmax ratio (RIR) were utilized to detect stenosis.
The SVmax was > 200 cm/sec in 6 cases, indicating renal artery stenosis (RAS). Angiographic evaluation of 5 patients revealed 3 had RAS > 60% and 2 had RAS < 60%. The 3 patients with RAS > 60% had RIR > 2. Increased vascular resistance in renal parenchyma was detected in 8 patients (1 acute rejection, 1 acute tubular necrosis, 6 histopathologically confirmed chronic rejection). Seventeen patients had one or more biopsies done during the follow-up. Six patients had a Doppler pattern compatible with arteriovenous fistula; two were confirmed by arteriography and one of these was embolized.
Duplex sonography is no substitute for the other methods utilized in the early detection of vascular complications in the renal graft, but it can identify those patients requiring angiographic assessment and can therefore reduce the number of biopsies for posttransplant evaluation.
确定肾脏双功超声在检测肾移植血管并发症中的作用。
对45例移植后中位随访时间为39.3±28.8个月的患者进行评估。利用肾动脉最大收缩速度（SVmax）和肾动脉/髂动脉SVmax比值（RIR）来检测狭窄。
6例患者的SVmax>200 cm/秒，提示肾动脉狭窄（RAS）。对5例患者进行血管造影评估显示，3例RAS>60%，2例RAS<60%。3例RAS>60%的患者RIR>2。8例患者检测到肾实质血管阻力增加（1例急性排斥反应，1例急性肾小管坏死，6例经组织病理学证实为慢性排斥反应）。17例患者在随访期间进行了一次或多次活检。6例患者的多普勒模式与动静脉瘘相符；2例经动脉造影证实，其中1例进行了栓塞治疗。
双功超声不能替代用于早期检测肾移植血管并发症的其他方法，但它可以识别那些需要进行血管造影评估的患者，因此可以减少移植后评估的活检次数。
