Journal of Ultrasound in Medicine, Vol 9, Issue 4 199-206, Copyright © 1990 by American Institute of Ultrasound in Medicine
Combined Doppler and morphologic sonographic evaluation of renal transplant rejection
R. R. Townsend, S. J. Tomlanovich, R. B. Goldstein and R. A. Filly
Department of Radiology, University of California School of Medicine, San Francisco.
We sought to evaluate whether results of Doppler ultrasound alone or in
combination with morphologic sonographic evaluation could predict acute
renal transplant rejection accurately enough to avoid biopsy. Seventy-one
patients were evaluated at time of biopsy. A resistive index greater than
0.90 was 100% predictive of acute rejection, but sensitivity was only 26%.
Resistive indices in acute and chronic rejection were often similar. When
all morphologic features were abnormal (11%), acute rejection was uniformly
present. Regression analysis selected resistive index over morphologic
features for ability to predict acute rejection. When resistive index is
greater than 0.90 or all morphologic features are abnormal, acute rejection
can be predicted with high accuracy, but biopsy remains necessary in many
cases.
