Opdenakker L, Oyen R, Vervloessem I, Goethuys H, Baert A L, Baert L V, Marchal G
Department of Radiology, University Hospitals, Leuven, Belgium.
Eur Radiol. 1998;8(8):1429-32. doi: 10.1007/s003300050568.
The aim of this study was to determine whether the intrarenal resistive index (RI) can be used for the diagnosis of acute obstruction in patients with renal colic and to determine whether the index is time-related. Seventy patients referred to the Emergency Department with acute renal colic and without known associated renal disease underwent duplex Doppler ultrasonography to determine the intrarenal RI at the symptomatic and asymptomatic side. The age range of the patients was 18-72 years. An RI greater than 0.68 and/or an interrenal difference in RI greater than 0.06 and/or an increase in RI of more than 11% compared with the normal side proved reliable cut-off values to diagnose acute renal obstruction. In addition, time dependency of the increase in RI was noted. No significant differences were observed within the first 6 h after the onset of symptoms. From 6 to 48 h, however, the mean RI in the affected kidney (0.70 +/- 0.06; mean +/- SD) was significantly different from that in the normal kidney (0.59 +/- 0.04) (P < 0.001). In the same period the mean difference in RI was 0.08-0.13 (P < 0.001). After 48 h the sensitivity of RI dropped substantially. It is concluded that renal duplex Doppler ultrasonography is useful for diagnosing acute renal obstruction between 6 and 48 h after the onset of symptoms.
本研究的目的是确定肾内阻力指数（RI）是否可用于诊断肾绞痛患者的急性梗阻，并确定该指数是否与时间相关。70例因急性肾绞痛就诊于急诊科且无已知相关肾病的患者接受了双功多普勒超声检查，以测定有症状侧和无症状侧的肾内RI。患者年龄范围为18至72岁。RI大于0.68和/或肾间RI差值大于0.06和/或与正常侧相比RI升高超过11%被证明是诊断急性肾梗阻的可靠临界值。此外，还注意到RI升高的时间依赖性。症状发作后的前6小时内未观察到显著差异。然而，在6至48小时期间，患侧肾脏的平均RI（0.70±0.06；平均值±标准差）与正常肾脏的平均RI（0.59±0.04）有显著差异（P<0.001）。在同一时期，RI的平均差值为0.08 - 0.13（P<0.001）。48小时后，RI的敏感性大幅下降。结论是，肾双功多普勒超声检查对于在症状发作后6至48小时内诊断急性肾梗阻是有用的。
