彩色多普勒超声在评估移植肾血管解剖及并发症方面的应用

发布时间：2018-06-09 20:15

本文选题：超声检查 + 彩色多普勒　；参考：《华中科技大学学报(医学版)》2015年03期

【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。
[Abstract]:Objective to evaluate the diagnostic value of color Doppler ultrasonography (CDU) in the evaluation of renal allograft anatomy and complications. Methods Seventy-eight patients with renal transplantation who needed to exclude vascular complications were examined by CDUS. Among them, 15 patients underwent digital subtraction angiography (DSAs) and 8 patients underwent surgery or interventional therapy because of renal vascular complications. The results of CDUS were compared with DSA and surgical records to analyze the diagnostic accuracy of CDUS in renal allograft anatomy and postoperative vascular complications. Results the coincidence rate of CDUs in 156 renal allograft vascular anastomoses was 97.4 / 156 in 78 patients, and 20 cases were correctly diagnosed by CDUS in 23 cases of renal vascular complications confirmed by DSA or surgery. This included 10 cases of graft renal artery stenosis, 3 cases of renal artery occlusion, 2 cases of renal artery occlusion, 1 case of arteriovenous fistula, 1 case of pseudoaneurysm, 2 cases of venous stenosis, 1 case of external iliac vein aneurysm, 2 cases of arteriovenous fistula, 3 cases of renal artery occlusion, 1 case of arteriovenous fistula and 1 case of external iliac vein aneurysm. The coincidence rate of ultrasound in the diagnosis of renal vascular complications was 86.9% or 20 / 23 / 78 cases of renal transplantation. Among the 78 cases of renal transplantation, 19 cases (24.3%) showed high peak systolic flow velocity (PSV) of 267.75 卤33.26 cm / s on the initial examination, and only 10 cases were finally diagnosed as renal graft stenosis. Conclusion CDUS can be used as the first choice to evaluate the vascular anatomy and vascular complications of renal allograft. PSV acceleration was not necessarily renal artery stenosis within half a year after transplantation, and should be followed up.
【作者单位】：华中科技大学同济医学院附属同济医院超声影像科;
【分类号】：R445.1;R699.2

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