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Arteriovenous Fistulas Following Percutaneous Needle Biopsy of the Kidney: Evaluation by Color Doppler Ultrasound

經皮腎臟穿刺併發之動靜脈瘻管:藉彩色都卜勒超音波評估

摘要


腎臟動靜脈瘻管是已熟知之經皮腎臟穿刺術的併發症之一。在兩個月間,我們藉由彩色都卜勒超音波,診斷出三例曾接受經皮腎臟穿刺後,而出現血尿症狀患者為動靜脈瘻管。在彩色都卜勒超音波上,其特徵為:局部組織振動,彩色訊號增強,高流速低阻抗波形,靜脈端動脈化,心縮期最高流速增加,及阻力指數降低等。三位患者之血管異常均經血管攝影證實,並以栓塞術治療之。因其為一非侵犯性且方便易用之影像工具,彩色都卜勒超音波在診斷及追蹤腎臟動靜脈瘻管方面,或在進一步施行栓塞術治療後的評估上,均是一極有價值的工具。

並列摘要


Intrarenal arteriovenous fistula (AVF) is a well-known complication of percutaneous needle biopsy (PNB) of the kidney. Using color Doppler ultrasound (CDUS), we diagnosed three patients of AVF who had hematuria following PNB. The color Doppler characteristics included local tissue vibrations, intense color signals, high velocity and low impedance flow wave forms, arterialization of the drainage vein, increased peak systolic velocity, and a decreased resistance index. All these patients were proved by arteriography and treated by transcatheter arterial embolization subsequently. As a noninvasive, easily available imaging tool, CDUS is a very useful modality in the diagnosis and follow up for patients with renal AVF, or in the work up of therapeutic embolization.

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