【摘要】 目的探讨彩色多普勒超声(CDUS)在评估移植肾血管解剖及并发症方面的诊断价值。方法对78例肾移植术后需排除血管并发症的患者进行CDUS扫查,其中15例患者进行了数字减影血管造影(DSA)检查,8例患者因移植肾血管并发症行手术或介入治疗。将CDUS结果与DSA及手术记录进行对比,分析CDUS对肾移植血管解剖及术后血管并发症的诊断符合率。结果 CDUS检查对78例患者的156条移植肾血管吻合方式的显示符合率为97.4%(152/156);23例经DSA或手术证实的移植肾血管并发症,CDUS正确诊断出其中20例,包括:10例移植肾动脉狭窄(TRAS),3例肾动脉闭塞,2例动脉扭曲成角,1例动静脉瘘,1例假性动脉瘤,2例静脉狭窄,1例髂外静脉瘤,超声对移植肾血管并发症诊断符合率为86.9%(20/23);78例肾移植患者中,19例(24.3%)初次检查时呈现较高的收缩期峰值流速(PSV)(267.75±33.26)cm/s,其中仅10例最终确诊为移植肾动脉狭窄。结论 CDUS可以作为评估移植肾血管解剖及血管并发症的首选方法。移植术后半年内,移植肾动脉PSV加快未必是肾动脉狭窄,需随访观察。更多还原

【Abstract】 Objective To evaluate the diagnostic value of color Doppler ultrasonography(CDUS)in the evaluation of transplant renal vascular anatomy and complications.Methods A total of 78 patients who underwent renal transplantation were examined with CDUS to identify vascular complications.Among these patients,15 were subjected to digital subtraction angiography(DSA).Surgery or interventional treatment was performed in 8patients who were found to develop renal vascular complications after transplantation.The accordance rate of CDUS in the evaluation of transplant renal vascular anatomy and in the diagnosis of vascular complications was obtained by comparing the CDUS results with DSA results or intraoperative findings.Results The accordance rate of CDUS in the evaluation of the vascular anastomosis(n=156)of transplanted kidneys was97.4%(152/156)in the 78 patients.Among the 23 cases of transplant renal vascular complications confirmed by DSA or operation,20 were also identified by CDUS,including 10 cases of transplant renal artery stenosis(TRAS),3cases of renal artery occlusion,2of artery kinking,1of arteriovenous fistula,1of pseudoaneurysm,2of vein stenosis,1of external iliac vein aneurysm.The diagnosis accordance rate was 86.9%(20/23).In the 78 patients with renal transplantion,19(24.3%)had a higher peak systolic velocity(PSV)(267.75±33.26)cm/s in the initial examination.Of them,only 10 were finally diagnosed as having renal artery stenosis.Conclusion CDUS may become the method of choice for the evaluation of transplant renal vascular anatomy and complications.High PSV of the transplant renal artery may not be a symbol of arterial stenosis within six months after transplantation and follow-up for these patients is required.更多还原