بررسی ارزش سونوگرافی داپلر در تشخیص رد پیوند کلیه

Background and purpose: Doppler sonography is a noninvasive diagnostic procedure with no side effect witch is cost effective and the results are rapidly available. Two indices are explained in the field of Doppler sonographic hemodynamic evaluation, PÏ* and RÏ**, Âbnormal ranges are PÏ ≥ 1.8 and RÏ ≥ 0.7 . Ïn previous studies average PÏ in normal conditions was 1.5 and in rejected transplanted kidneys was 2.53 and averages RÏ in normal and rejected kidneys were 0.69 and 0.83 respective. Transplanted kidney in likely rejected if RÏ ≥ 0.9 . However none of previous studies determined witch of these indices are more sensitive in diagnoses of rejected kidney. This study is performed to determine witch one of the indices (PÏ or RÏ) are better correlated with gold standard (Pathological examination). Materials and Methods: Method of study was test assessing (Process research) and the instrument used, was Âlok Doppler with 3.5 mHz probe with assistance of two specialists. Ïn each examination patients with clinical and biochemical diagnosis of rejection was examined by doppler sonography, then was sonography biopsied and at the end if pathological study conformed rejection, Doppler results (PÏ & RÏ) was compared with pathological examination results. * PÏ=Pulsatility Ïndex = Peak systolic Velosity – end diastolic Velosity Mean ** RÏ=Pesistive Ïndex = Peak systolic Velosity – end diastolic Velosity Peak systolic Velosity Results: Ôf total number of 17 patients examined 10 were men (59%) and 7 women (41%). Âverage PÏ was 2.21 and average RÏ was 0.87. 14 patients (82%) showed abnormal RÏ and 16 patients (94%) showed abnormal PÏ and 10 patients showed RÏ ≥ 0.9 . Çonclusion: Ïn this study 94% of patients whose pathological study results had confirmed rejection showed abnormal PÏ and 82% abnormal RÏ so abnormal PÏ better correlates with pathological study results than abnormal PÏ with biopsy results.