Karadeniz T, Topsakal M, Eksioğlu A, Ariman A, Basak D
Department of Urology, SSK Okmeydani Hospital, Istanbul, Turkey.
Eur Urol. 1996;29(3):298-301. doi: 10.1159/000473764.
Prior animal studies have shown through direct pressure measurements that there is a definite rise in the renal vascular resistance in obstruction. Therefore intrarenal hemodynamic changes can be determined by the vascular impedance expressed as pulsatility and resistive indexes (PI and RI) obtained from the Doppler waveforms of intrarenal arteries. We investigated whether various degrees of obstruction result in different hemodynamic responses according to color Doppler sonography.
22 kidneys with varied degrees of hydronephrosis and 19 normal kidneys were examined. The pulsatility and resistive index of Doppler waveforms from interlobar arteries were obtained. The grade of hydronephrosis was based upon the width of parenchyma.
The mean resistive index in the study and controls were 0.70 +/- 0.07 and 0.60 +/- 0.03, respectively. The difference was significant (p < 0.001). Pulsatility indexes in the study and controls were 1.07 +/- 0.34 and 0.98 +/- 0.23, respectively. The difference was not significant (p > 0.005). Significant difference was also noticed in the parenchymal widths between both groups (p < 0.001).
It appeared that intrarenal color Doppler sonography can provide physiologic information reflecting renal vascular resistance status by means of an easily obtained parameter: resistive index.
先前的动物研究通过直接压力测量表明，梗阻时肾血管阻力会明显升高。因此，肾内血流动力学变化可以通过从肾内动脉多普勒波形获得的以搏动性和阻力指数（PI和RI）表示的血管阻抗来确定。我们根据彩色多普勒超声检查，研究了不同程度的梗阻是否会导致不同的血流动力学反应。
对22个不同程度肾积水的肾脏和19个正常肾脏进行检查。获取叶间动脉多普勒波形的搏动性和阻力指数。肾积水的分级基于实质宽度。
研究组和对照组的平均阻力指数分别为0.70±0.07和0.60±0.03。差异具有统计学意义（p<0.001）。研究组和对照组的搏动指数分别为1.07±0.34和0.98±0.23。差异无统计学意义（p>0.005）。两组间实质宽度也存在显著差异（p<0.001）。
肾内彩色多普勒超声似乎可以通过一个易于获得的参数：阻力指数，提供反映肾血管阻力状态的生理信息。
