Renal dysfunction in liver cirrhosis: renal duplex Doppler US vs. scintigraphy for early identification
| Autor: | E.A.R. Al-Kareemy, M.A. Sobh, R.A. Saber, M.M. Mostafa, A.M. Muhammad |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Time Factors Urology Hemodynamics Renal function Scintigraphy Severity of Illness Index medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Risk factor Ultrasonography Doppler Color medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Surgery medicine.anatomical_structure Evaluation Studies as Topic Pulsatile Flow Vascular resistance Technetium Tc 99m Pentetate Female Kidney Diseases Vascular Resistance Radiopharmaceuticals Complication business Radioisotope Renography Kidney disease |
| Zdroj: | Clinical radiology. 53(1) |
| ISSN: | 0009-9260 |
| Popis: | A diagnostic tool to detect early renal dysfunction before it becomes irreversible would be useful in cirrhosis. This study was carried out to evaluate the role of Doppler sonography and Tc-99m DTPA renography in the detection of early renal dysfunction in patients with different grades of liver cirrhosis. Renal arteries of 43 patients with cirrhosis and normal renal function tests were compared with 15 age and gender matched normal subjects as a control group using colour Doppler sonography and Tc-99m DTPA scintigraphy. The patients were categorized into three groups, A (14), B (14) and C (15), according to a modified Child's classification that assesses the severity of liver cirrhosis. Doppler results revealed a highly significant increase in both the pulsatility and resistive indices in groups B and C compared with either group A patients or control subjects and in group C compared with group B (P0.001) in the main renal arteries as well as in the interlobar and arcuate arteries. Insignificant differences were observed between group A and controls (PI: control 0.96+/-0.08, group A 0.95+/-0.07, group B 1.26+/-0.06, group C 1.48+/-0.06; RI: control 0.57+/-0.02, group A 0.58+/-0.02, group B 0.66+/-0.01, group C 0.72+/-0.02). Abnormal renograms in the form of delayed appearance (34+/-14.6 s), diminished blood flow bilaterally with prolonged secretory (12+/-4.5 min) and excretory phases (30 min) and poor response to intravenous frusemide were only observed in group C patients. Radionuclide computed glomerular filtration rate was within the normal range in patients of group A (81+/-9.5 ml/min) and group B (78+/-8.4 ml/min) and reduced only in patients of group C (34+/-14.5 ml/min). Thus Doppler sonography can detect an increase in renal vascular resistance in patients with moderately severe cirrhosis (Child grade B) when renography was normal. We conclude that Doppler sonography can be used for earlier identification of cirrhotic patients with a higher risk of impending renal failure earlier than renography and may also be used to guide therapeutic approaches. |
| Databáze: | OpenAIRE |
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