Application Of Color Doppler Ultrasonography In The Diagnosis And Differential Diagnosis Of AR And ATN After Renal Transplantation

With the quick development of immunity research, surgical technique andcontinuous progress of drug treatment, renal transplantation becomes the ideal method forend stage renal disease. However, acute rejection(AR) and acute tubular necrosis(ATN) isthe commonest reason of oliguria or anuria in patients with renal transplantation; at thesame time, it's very difficult for us to differentiate AR and ATN in clinic, whether ARcould get early diagnosis and treatment is the key for transplanted kidney to live longterm. For it's simplicity, quickness, without trauma, reproducibility and reliability, colorDoppler ultrasonography is the first selection of clinic supervising transplanted kidney;there is still controversy about it's role in differentiation between AR and ATN.Objectives: Study blood irrigation and blood index fluctuation of transplantedkidney during the development and progression of AR and ATN by color Doppler;evaluate the role of color Doppler ultrasonography in diagnosing and differentiatingbetween AR and ATN of transplanted.Methods: According to the condition and function after operation, 220 patients withrenal transplantation were divided as normal function group(n=149), AR group(n=52) andATN group(n=19). AR and ATN were diagnosed by their clinic symptoms and signs,laboratory examination or biopsy of transplanted kidney. LOGIQ9 color Dopplerultrasonoscope(GE company, America) and detecting head frequency 3.5 MHz were usedfor testing the length, blood flow and renal artery flow parameters of the transplantedkidney; these parameters were compared and evaluated between each group.Results: The length and parenchymal thickness of AR group is longer significantlythan that of normal group (P＜0.01). The length and parenchymal thickness of ATN group is longer slightly than that of normal group, but there is no apparent difference (P＞0.05).The RI of Both AR and ATN group show obviously higher than that of normal group(bothP＜0.01), but there is no difference between AR and ATN group(P＞0.05).Conclusion: Examinating thc size and RI of transplanted kidney by color Dopplerultrasonography could play important role in diagnosis and differentiation of AR andATN.