CAJ | 학술논문

目的：探讨彩色多普勒超声技术用于评价移植肾动脉狭窄（transplant renal artery stenosis ，TRAS）的临床价值。方法：回顾分析经彩色多普勒超声检查怀疑为 TRAS的19例患者的临床资料和超声检查结果，超声指标包括肾主动脉峰值流速（PSV）、峰值流速后比（肾主动脉PSV／叶间动脉PSV）和叶间动脉阻力指数（RI）。随机选取同期的移植肾功能稳定的25例患者作为对照组。以经数字减影血管造影（DSA ）或磁共振血管造影（M RA ）作为诊断“金标准”，对检查结果进行对比分析。将经DSA或MRA确诊为TRAS的患者作为狭窄组。结果：19例中有狭窄者13例，超声诊断假阳性2例；4例患者未行DSA或MRA检查。狭窄组肾主动脉PSV、峰值流速后比均较正常组明显升高（P＜0．001），而叶间动脉RI明显降低（P＜0．001）；TRAS患者经肾动脉扩张或支架置入后，超声各指标发生显著改变（P＜0．01）。结论：彩色多普勒超声是筛查移植肾动脉狭窄的首选影像学方法。
목적：탐토채색다보륵초성기술용우평개이식신동맥협착（transplant renal artery stenosis ，TRAS）적림상개치。방법：회고분석경채색다보륵초성검사부의위 TRAS적19례환자적림상자료화초성검사결과，초성지표포괄신주동맥봉치류속（PSV）、봉치류속후비（신주동맥PSV／협간동맥PSV）화협간동맥조력지수（RI）。수궤선취동기적이식신공능은정적25례환자작위대조조。이경수자감영혈관조영（DSA ）혹자공진혈관조영（M RA ）작위진단“금표준”，대검사결과진행대비분석。장경DSA혹MRA학진위TRAS적환자작위협착조。결과：19례중유협착자13례，초성진단가양성2례；4례환자미행DSA혹MRA검사。협착조신주동맥PSV、봉치류속후비균교정상조명현승고（P＜0．001），이협간동맥RI명현강저（P＜0．001）；TRAS환자경신동맥확장혹지가치입후，초성각지표발생현저개변（P＜0．01）。결론：채색다보륵초성시사사이식신동맥협착적수선영상학방법。
Objective:To investigate the clinical value of color Doppler flow imaging (CDFI)for evaluating transplant renal artery stenosis (TRAS) .Methods:Clinical data and ultrasonography results of 19 patients with suspected TRAS ,which were evaluated by CDFI ,were retrospectively analyzed .CDFI indexes included the peak systolic velocity (PSV) in the main renal artery ,a ratio of the PSV in the main renal artery to that in the interlobar arteries (the POST‐ PSV ratio) and the resistant index (RI) in the interlobar arteries .The randomly enrolled 25 patients with stable transplant renal function were set as control group .The examination results were evaluated by “gold standard” digital subtraction angiography (DSA ) or magnetic resonance angiography .Paeients with TRAS diagnosed by DSA or MRA were set as stenosis group .Results:Thirteen casts showed stenosis .There were 2 false positive cases for CDFI diagnosis .And 4 cases did not undergo DSA or MRA examination . Compared with that in the control group ,the PSV of the main renal artery and the POST‐ PSV ratio in the stenosis group increased significantly(P<0 .001) ,however ,the RI in the interlobar arteries decreased significantly(P<0 .001) .CDFI indexes remarkably changed after the TRAS patients had undergone renal artery dilatation or stent implantation .Conclusions:CDFI is a reliable first choice method for screening transplant renal artery stenosis .