de Toledo L S, Martínez-Berganza Asensio T, Cozcolluela Cabrejas R, de Gregorio Ariza M A, Pardina Cortina P, Ripa Saldias L
Department of Radiology, Reina Sofia Hospital, Navarra, Spain.
Eur J Radiol. 1996 Sep;23(2):143-8. doi: 10.1016/0720-048x(96)01055-8.
To determine the role of intrarenal Doppler ultrasound (US) in patients with renal colic and to establish the usefulness of this diagnostic method.
In 121 patients with renal colic and 70 healthy individuals, 382 kidneys were examined with color duplex US. Mean intrarenal-arterial resistive index (RI), and the difference of mean RIs (dRI) between both kidneys were determined. In 64 patients, RI and dRI were compared with urographic findings (time of delay pyelogram between both kidneys).
In the 70 healthy individuals, RI was 0.62 +/- 0.045 and dRI 0.018 +/- 0.01. In the 121 patients with renal colic, RI (0.71 +/- 0.06) was significantly superior (P < 0.001) with respect to the opposite kidney, with a dRI of 0.09 +/- 0.055. In a correlation performed in 64 patients with urographic findings among color doppler US, with a RI > or = 0.70 and/or dRI > or = 0.06 as an indicative value of obstruction, sensitivity and specificity were 91.8% for patients with delayed pyelogram (n = 37 patients), and 48.1% for patients with nondelayed pyelogram (n = 27 patients) with a specificity of 92.8% with respect to the group of normal patients. In the group of patients with delayed pyelogram, RI was significantly superior (P < 0.05) in patients with an evolution time greater than 24 hours, in patients with proximal ureteral obstruction and in patients who had signs of pyelonephritis. There were no significant differences in the group of patients with nondelayed pyelograms.
Color Doppler US is useful to fundamentally evaluate the consequences of the obstruction on renal function. Other factors such as evolution time of the symptomology, obstruction level, or existence of pyelonephritis can alter the US-Doppler values.
确定肾内多普勒超声（US）在肾绞痛患者中的作用，并确立这种诊断方法的实用性。
对121例肾绞痛患者和70例健康个体的382个肾脏进行了彩色双功超声检查。测定了平均肾内动脉阻力指数（RI）以及双肾之间平均RI的差值（dRI）。在64例患者中，将RI和dRI与尿路造影结果（双肾延迟肾盂造影时间）进行了比较。
在70例健康个体中，RI为0.62±0.045，dRI为0.018±0.01。在121例肾绞痛患者中，RI（0.71±0.06）相对于对侧肾脏显著更高（P<0.001），dRI为0.09±0.055。在64例进行了彩色多普勒超声与尿路造影结果相关性分析的患者中，以RI≥0.70和/或dRI≥0.06作为梗阻的指示值，肾盂造影延迟患者（n = 37例）的敏感性和特异性分别为91.8%，肾盂造影未延迟患者（n = 27例）的敏感性和特异性分别为48.1%，相对于正常患者组特异性为92.8%。在肾盂造影延迟的患者组中，病程超过24小时的患者、输尿管上段梗阻患者以及有肾盂肾炎体征的患者，RI显著更高（P<0.05）。肾盂造影未延迟的患者组中无显著差异。
彩色多普勒超声有助于从根本上评估梗阻对肾功能造成的影响。其他因素，如症状的病程、梗阻程度或肾盂肾炎的存在，可改变超声多普勒值。
