[Intra-renal ultrasound and color Doppler: pathology or nephrologic significance].

S Montemezzi, P Saggin, L Zonta, G Gortenuti
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Abstract

Us-Doppler examination of the native kidney gives more detailed information on nephrological vascular disease. Since there is a close connection between renal functional units (nephrons) and vascular and interstitial compartments, alterations in intrarenal flow will obviously occur in all types of medical nephropathy, irrespective of the origin of the anatomopathological damage. Altered intrarenal flow occur with increased vascular impedance, in turn related to an increased resistance index (RI). In nephropathy with dilatation, the RI can distinguish obstructive from non-obstructive dilatation (high and normal RI, respectively). Personal experience of 80 kidneys with nonobstructive medical nephropathy has shown a good correlation between increased RI and deterioration of renal function, demonstrating that, renal function being equal, RI is higher in Vascular than Tubulo-interstitial and Glomerular nephropathies. For medical nephropathy of transplanted kidneys, Us-Doppler evaluation can be combined with conventional Doppler for diagnosing acute rejection. In this series, an elevated RI (0.90) is highly predictive of acute rejection (92% specificity) but has low sensitivity (30%). At the threshold value of RI = 0.80, sensitivity is 66% and specificity is 78%. However, it is considered that far more reliable information is obtained if Doppler examination is combined with conventional U.S. morphology.

【肾内超声及彩色多普勒:病理或肾病学意义】。
原生肾脏的Us-Doppler检查可提供肾脏血管疾病的更详细信息。由于肾脏功能单位(肾单位)与血管和间质室之间存在密切联系,因此无论解剖病理损伤的来源如何,所有类型的内科肾病都会明显发生肾内血流的改变。肾内血流的改变伴随着血管阻抗的增加而发生,这反过来又与阻力指数(RI)的增加有关。在伴有扩张的肾病中,RI可以区分阻塞性和非阻塞性扩张(分别为高和正常的RI)。80例非阻塞性内科肾病患者的个人经验表明,RI升高与肾功能恶化之间存在良好的相关性,表明在肾功能相同的情况下,血管肾病的RI高于小管间质肾病和肾小球肾病。对于移植肾内科肾病,超声多普勒可与常规多普勒联合诊断急性排斥反应。在本研究中,RI升高(0.90)可高度预测急性排斥反应(92%特异性),但敏感性较低(30%)。在RI = 0.80的阈值下,敏感性为66%,特异性为78%。然而,如果多普勒检查与常规美国形态学相结合,则被认为获得更可靠的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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