Duplex Doppler Evaluation of Renal Allograft Dysfunction: Doppler Signal Quantitation
The differential diagnosis of acute tubular necrosis (ATN), cyclosporin nephrotoxicity (CNT), acute allograft rejection (AR) and chronic allograft rejection (CR) as causes of renal graft dysfunction remains difficult. The search for a modality which can predict and differentiate between these different renal allograft complications has intensified in recent years. Recently, duplex Doppler evaluation has shown promise in the characterization of transplant dysfunction [1–4]. In some causes of renal allograft dysfunction there is an elevation in vascular impedance of the graft which results in a decrease of diastolic flow velocity in the branches of the renal arterial vasculature [3,4]. This is reflected by morphological changes of the Doppler curve, on the one hand, and by changes in quantitative parameters, on the other [5–8].
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