Diagnostic Efficacy Of Color Doppler Ultrasound On Transplant Renal Artery Stenosis

Objective:To explore the value of Color Doppler ultrasound d(CDUS)in the diagnosis of transplant renal artery stenosis(TRAS)during the postoperative follow up of renal transplantation.Methods:CDUS parameters and clinical manifestations of 287 patients who underwent renal transplant from January 2014 to December 2016 in the center were enrolled.The 95% confidence interval of CDUS parameters of non-TRAS patients was statistically analyzed to establish the threshold value of CDUS in diagnosing TRAS.69 kidney transplant recipients were screened by using new CDUS thresholds from January 2017 to September 2017.Within 1 month after CDUS examination,all patients were scheduled for MRA of renal graft.Patients suspected of TRAS were eventually diagnosed by digital subtraction angiography(DSA)and diagnostic accuracy of the new CDUS thresholds was calculated compare to DSA diagnostic results at this stage.Results:A renal artery peak systolic velocity(PSV)>250 cm/s,which was used as CDUS threshold to diagnose TRAS,showed a sensitivity of 83.3% and a specificity of 96.8%.ratio of renal artery PSV/interlobar artery PSV>10 and interlobar artery resistance index(RI)<0.51 presented sensitivities of 83.3% and 33.3% and specificities of 98.4% and 98.4%,respectively.Conclusions:We propose a CDUS diagnostic criterion combined with clinical manifestations as follows:(1)CDUS thresholds were transplant renal artery PSV>250 cm/s(2)Ratio of renal artery PSV/interlobar artery PSV>10.(3)Symptoms include elevated serum creatinine or refractory hypertension.Patients suspected TRAS need to meet(3)+((1)or(2))or(1)+(2).Patients who suspected TRAS were finally confirmed by further DSA examination.CDUS aided the early diagnosis of TRAS in the postoperative follow up of renal transplantation.