The application of Doppler ultrasonography in children′s transplant renal artery stenosis

Abstract

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 non-stenosis 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 non-stenosis 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. Key words: Ultrasonography, Doppler, color; Kidney transplantation; Renal artery Obstruction; Child