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Evaluation of severe transplant renal artery stenosis with Doppler sonography.

Publication ,  Journal Article
Li, JC; Ji, ZG; Cai, S; Jiang, YX; Dai, Q; Zhang, JX
Published in: Journal of clinical ultrasound : JCU
2005

PURPOSE: To evaluate and determine Doppler criteria for predicting a severe transplant renal artery stenosis (80%-99% diameter reduction) and to compare the Doppler findings in patients with end-to-end and end-to-side anastomosis. METHODS: We performed Doppler sonography on 16 consecutive patients with transplant renal artery stenosis (TRAS) confirmed by digital subtraction arteriography (DSA). Fourteen patients had end-to-end anastomosis, and 2 had end-to-side anastomosis. Eleven patients were re-evaluated with color Doppler sonography within 4 days after intervention. Seven Doppler parameters, including the peak systolic velocity (PSV) in the renal, iliac and interlobar artery, Pre-PSV ratio (the ratio of the PSV in the renal artery to that in the iliac artery), Post-PSV ratio (the ratio of the PSV in the renal artery to that in the interlobar arteries, acceleration time and resistance index, were measured. In the patients with severe TRAS the measurements of these parameters were compared before and after successful intervention. RESULTS: In the 16 patients with a single transplanted kidney, arteriography demonstrated 14 main renal arteries with severe stenosis, and 3 renal arteries with moderate stenosis. When using the cutoff values of Post-PSV ratio >13, renal artery PSV >4 m/sec, acceleration time >0.06 second, and resistance index 5 had sensitivities of 86% and 100%, respectively. Pre-PSV ratios in severe stenoses of end-to-end anastomosis (range, 5.1-11.5) were significantly greater than those recorded in severe stenoses of end-to-side anastomosis (range, 2.8-3.1). Statistically significant differences before and after successful intervention were found for all 7 Doppler parameters in the 7 patients with severe stenosis. CONCLUSIONS: An 80%-99% diameter reduction of the renal artery can be diagnosed based on a Post-PSV ratio >13 for patients with either end-to-end or end-to-side anastomosis. A Pre-PSV ratio >5 for patients with end-to-end anastomosis and acceleration time >0.06 second are helpful in the diagnosis of severe TRAS.

Duke Scholars

Published In

Journal of clinical ultrasound : JCU

ISSN

0091-2751

Publication Date

2005

Volume

33

Issue

6

Start / End Page

261 / 269

Location

united states

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Li, J. C., Ji, Z. G., Cai, S., Jiang, Y. X., Dai, Q., & Zhang, J. X. (2005). Evaluation of severe transplant renal artery stenosis with Doppler sonography. Journal of Clinical Ultrasound : JCU, 33(6), 261–269.
Li, J. C., Z. G. Ji, S. Cai, Y. X. Jiang, Q. Dai, and J. X. Zhang. “Evaluation of severe transplant renal artery stenosis with Doppler sonography.Journal of Clinical Ultrasound : JCU 33, no. 6 (2005): 261–69.
Li JC, Ji ZG, Cai S, Jiang YX, Dai Q, Zhang JX. Evaluation of severe transplant renal artery stenosis with Doppler sonography. Journal of clinical ultrasound : JCU. 2005;33(6):261–9.
Li, J. C., et al. “Evaluation of severe transplant renal artery stenosis with Doppler sonography.Journal of Clinical Ultrasound : JCU, vol. 33, no. 6, 2005, pp. 261–69.
Li JC, Ji ZG, Cai S, Jiang YX, Dai Q, Zhang JX. Evaluation of severe transplant renal artery stenosis with Doppler sonography. Journal of clinical ultrasound : JCU. 2005;33(6):261–269.
Journal cover image

Published In

Journal of clinical ultrasound : JCU

ISSN

0091-2751

Publication Date

2005

Volume

33

Issue

6

Start / End Page

261 / 269

Location

united states

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • 1103 Clinical Sciences