• AJR Am J Roentgenol · Mar 1989

    Duplex Doppler sonography of renal transplants: lack of sensitivity and specificity in establishing pathologic diagnosis.

    • S M Genkins, F P Sanfilippo, and B A Carroll.
    • Department of Radiology, Duke University Medical Center, Durham, NC 27710.
    • AJR Am J Roentgenol. 1989 Mar 1;152(3):535-9.

    AbstractRecent reports have suggested the value of duplex Doppler sonography in the assessment of renal transplant function. Accurate diagnosis of acute rejection and its distinction from acute tubular necrosis and cyclosporine A toxicity have been claimed. We undertook a combined retrospective and prospective analysis of duplex Doppler examinations performed over a 2-year period to assess the value of such studies in evaluating renal allograft dysfunction. Seventy-seven sonographic examinations were performed on 77 renal transplants. A mean resistive index was calculated from Doppler measurements within main, segmental, and interlobar renal arteries by using the following ratio. peak systolic blood-flow velocity--minimum end-diastolic blood-flow velocity/peak systolic blood-flow velocity Forty-eight Doppler results were correlated with transplant biopsies and 29 with clinical course. Twenty-three episodes of acute allograft rejection were confirmed. When a resistive index of greater than or equal to 0.9 was used to indicate acute rejection, sonography had a sensitivity of only 9% and a specificity of 91% for this diagnosis. In one of eight cases of cyclosporine A toxicity and in three of six examples of acute tubular necrosis, the resistive index was greater than 0.9. In all six instances of chronic rejection, the resistive index was less than 0.84. None of eight patients with evidence of infection had a resistive index greater than 0.9. The resistive index range of 12 normally functioning allografts was 0.57-0.69. Correlation between the resistive index and the severity of arterial and arteriolar changes on biopsy was poor. An increased resistive index of renal transplant blood flow, as measured by duplex Doppler sonography, usually signals pathologic changes in an allograft. However, our data indicate that this test is not as sensitive or specific in identifying the cause of transplant dysfunction as has been suggested previously.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…