摘要
目的探讨儿童移植肾肾动脉狭窄(TRAS)的彩色多普勒超声诊断价值。方法回顾性分析82例临床疑诊TRAS的儿童肾移植患者的超声检查结果和临床资料,根据计算机断层扫描血管造影(CTA)检查结果分为狭窄组(21例)和非狭窄组(61例),分析两组患者移植肾超声血流动力学参数的差异。根据ROC曲线选择预测TRAS的最佳血流动力学参数及截断值,并计算其敏感性及特异性。经Logistic回归筛选TRAS的独立预测指标。结果与非狭窄组相比,狭窄组肾主动脉收缩期峰值流速(PSV)、肾主动脉PSV/叶间动脉PSV(即峰值流速后比)及叶间动脉的加速时间(AT)增高,叶间动脉PSV降低(均P<0.05)。肾主动脉PSV为218.5cm/s,叶间动脉PSV为25.5cm/s,峰值流速后比为7.2,叶间动脉AT为67.5ms时,预测儿童TRAS的敏感性及特异性最高,可作为筛查儿童TRAS的超声阈值。叶间动脉PSV可作为TRAS的独立预测指标。结论彩色多普勒超声评估移植肾各级动脉血流动力学改变对预测儿童TRAS具有临床实用价值。
Objective To explore the value of color Doppler ultrasonography in diagnosis of transplant renal artery stenosis(TRAS)of children.Methods The results of ultrasound examination and clinical data of 82 kidney transplant children with suspected TRAS were retrospectively analyzed.According to the results of the CTA,the enrolled children were divided into a stenosis group with 21 cases and a nonstenosis group with 61 cases.The differences of ultrasound hemodynamic parameters between the two groups were compared.The hemodynamic parameters and cutoff values of prediction of TRAS were determined according to the ROC curve,and the corresponding sensitivity and specificity were calculated. Logistic regression was used to screen TRAS independent predictors.Results Compared with the nonstenosis group,the peak systolic velocity (PSV)of the renal aorta,the renal aorta PSV/interlobular artery PSV (post PSV ratio)and acceleration time (AT)of interlobular artery in the stenosis group were significantly higher,but the PSV of the interlobular artery was lower (all P<0.05).Differences of indicators between the two groups can be used to predict TRAS.Through the ROC curve the peak systolic velocity of the renal aorta and the interlobular artery were 218.5 cm/s and 25.5 cm/s,respectively,the post PSV ratio was 7.2,and the AT of intervein arterial was 67.5 ms,the sensitivity and specificity were the highest,which could be used as the ultrasound screening threshold.The PSV of the interlobular artery can be used as an independent predictor of TRAS.Conclusions Analysis of hemodyamic parameters of transplanted kidney arteries by Doppler ultrasonography might be useful in predicting TRAS in children.
作者
王娇娇
李金锋
齐清华
张艳
滑少华
董刚
Wang J iaojiao;Li Jinfeng;Qi Qinghua;Zhang Yan;Hua Shaohua;Dong Gang(Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2018年第11期953-957,共5页
Chinese Journal of Ultrasonography
关键词
超声检查
多普勒
彩色
肾移植
肾动脉梗阻
儿童
Ultrasonography,Doppler,color
Kidney transplantation
Renal artery Obstruction
Child
