Ultrasound images of Vascular occlusion
Ultrasound images of Colour and spectral Doppler are essential for the diagnosis of postoperative vascular complications. Non-perfusion may be total or lobar (Fig. ultrasound images below).
Focal areas of hypoperfusion may be due to oedema in focal infection, arteriovenous fistula or severing of an accessory artery during harvesting of the transplant or at the time of implantation. Total vascular occlusion is rare, but occurs early. Patients may be asymptomatic and non-perfusion of the transplant may be inadvertently seen on either a routine scan or isotope study. Graft nephrectomy is the most likely outcome. Conversely, the appearance of good renal perfusion throughout the kidney on colour or power Doppler does not necessarily indicate normal vascularity and severe vascular rejection or acute tubular necrosis can be present under such circumstances. Vascular complications can include arterial stenosis or thrombosis, venous stenosis or thrombosis, pseudoaneurysms and arteriovenous fistulae.
Focal areas of hypoperfusion may be due to oedema in focal infection, arteriovenous fistula or severing of an accessory artery during harvesting of the transplant or at the time of implantation. Total vascular occlusion is rare, but occurs early. Patients may be asymptomatic and non-perfusion of the transplant may be inadvertently seen on either a routine scan or isotope study. Graft nephrectomy is the most likely outcome. Conversely, the appearance of good renal perfusion throughout the kidney on colour or power Doppler does not necessarily indicate normal vascularity and severe vascular rejection or acute tubular necrosis can be present under such circumstances. Vascular complications can include arterial stenosis or thrombosis, venous stenosis or thrombosis, pseudoaneurysms and arteriovenous fistulae.
ultrasound images of Lack of perfusion in the upper pole due to rejection
Ultrasound images of High-velocity jet at the site of a magnetic
resonance angiography stenosis. This patient had had increasing, badly controlled hypertension since his transplant.
resonance angiography stenosis. This patient had had increasing, badly controlled hypertension since his transplant.
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