Martinoli C, Bertolotto M, Crespi G, Pretolesi F, Valle M, Derchi L E
Cattedra "R" di Radiologia, Università di Genova, I-16 132 Genova, Italy.
Eur Radiol. 1998;8(5):765-9. doi: 10.1007/s003300050469.
The aim of our study was to analyze changes in spectral Doppler waveforms between interlobar and interlobular arteries in renal transplants and to determine whether sampling location at interlobular level can be suitable for intrarenal resistive index (RI) measurements. Paired series of spectral tracings from interlobar arteries and respective interlobular branches were obtained in 62 consecutive renal transplants at 6.5-MHz Doppler frequency. The values of peak systolic velocity (PSV), end diastolic velocity (EDV) and RI were significantly (P < 0.01) reduced when calculated at interlobular level. In 38 % of cases, an interlobar RI higher than 0.70 corresponded to a normal interlobular RI. The values of PSV, EDV, and RI did not differ significantly at interlobular level between allograft subsets with normal and elevated serum creatinine level. Both intra- and interobserver variation were higher at interlobular than at interlobar level when performing the RI. During a conventional study of renal vasculature, an underestimation of abnormal RI findings can be expected from the incidental evaluation of interlobular tracings. We recommend sonologists to pay attention in accurately locating the sample volume at interlobar-arcuate level when evaluating intrarenal RI.
我们研究的目的是分析肾移植中肾叶间动脉和小叶间动脉之间频谱多普勒波形的变化，并确定在小叶间水平的采样位置是否适合测量肾内阻力指数（RI）。在62例连续肾移植中，以6.5MHz多普勒频率获取肾叶间动脉及其相应小叶间分支的配对频谱描记图系列。在小叶间水平计算时，收缩期峰值速度（PSV）、舒张末期速度（EDV）和RI值显著降低（P<0.01）。在38%的病例中，肾叶间RI高于0.70对应正常的小叶间RI。在血清肌酐水平正常和升高的同种异体移植亚组中，小叶间水平的PSV、EDV和RI值无显著差异。在进行RI测量时，小叶间的观察者内和观察者间变异均高于肾叶间水平。在对肾血管系统进行常规研究时，从小叶间描记图的偶然评估中可能会低估异常RI结果。我们建议超声科医生在评估肾内RI时，注意将取样容积准确置于肾叶间-弓状动脉水平。
