Skip to main content

Noninvasive Assessment of Human Renal Blood Flow by Ultrasonic Doppler Flowmetry

  • Conference paper
Renovascular and Renal Parenchymatous Hypertension

Abstract

Owing to its noninvasive, nontraumatic nature, ultrasonic Doppler flowmetry (DF) is well established in clinical medicine [1]. A large medical-industrial complex exists for the development, marketing, and distribution of these diagnostic instruments. Recently, image-guided DF has been applied to the deep-lying blood vessels of the human abdomen [2, 3]. Specifically, early attempts were made to examine native human renal arteries [4, 5] and renal grafts [6, 7]. Many subsequent reports have followed. We will review the basic principles of noninvasive DF and its present applications to the human renal vasculature. As with all diagnostic tests, interpretation of the reported results in renal vessels should be made with careful consideration of the study design and the control of bias [8, 9].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Taylor KJW, Burns PN, Wells PNT (eds) (1989) Clinical application of Doppler ultrasound. Raven, New York

    Google Scholar 

  2. Taylor KJW, Burns PN (1985) Duplex Doppler scanning in the pelvis and abdomen. Ultra-sound Med Biol 11(4)643–658.

    Article  CAS  Google Scholar 

  3. Taylor KJW, Burns PN, Woodcock JP, Wells PNT (1985) Blood flow in deep abdominal and pelvic vessels: ultrasonic pulsed-Doppler analysis. Radiology 154 (2): 487–493

    PubMed  CAS  Google Scholar 

  4. Greene ER, Venters MD, Avasthi PS, Conn RL, Jahnke RW (1981) Noninvasive characterization of renal artery blood flow. Kidney Int 20: 523–529

    Article  PubMed  CAS  Google Scholar 

  5. Reid MH, Mackay RS, Lantz BMT (1980) Noninvasive blood flow measurements by Doppler ultrasound with applications to renal artery flow determination. Invest Radiol 15: 323–331

    Article  PubMed  CAS  Google Scholar 

  6. Berland LL, Lawson TL, Adams MB, Melrose BL, Foley WD (1982) Evaluation of renal transplants with pulsed Doppler duplex sonography. J Ultrasound Med 1: 215–222

    PubMed  CAS  Google Scholar 

  7. Wood RFM, Nasmyth DG (1982) Doppler ultrasound in the diagnosis of vascular occlusion in renal transplantation. Transplantation 33 (5): 547–551

    Article  PubMed  CAS  Google Scholar 

  8. Begg CB, McNeil BJ (1988) Assessment of radiologic tests: control of bias and other design considerations. Radiology 167: 565 - 569

    PubMed  CAS  Google Scholar 

  9. Chang PJ (1989) Bayesian analysis revisted: a radiologist’s survival guide. Am J Radiol 152: 721–727

    CAS  Google Scholar 

  10. McDonald DA (1974) Blood flow in arteries. Williams and Wilkins, Baltimore

    Google Scholar 

  11. Liepsch D, Moravec S (1979) Qualitative and quantitative stromungsuntersuchungen an einem menschlichen nierenarterienmodell: qualitative and quantitative flow studies in a model of human renal arteries. Biomed Tech 24: 184–191

    Article  CAS  Google Scholar 

  12. Avasthi PS, Greene ER, Voyles WF (1987) Noninvasive Doppler assessment of human postprandial renal blood flow and cardiac output. Am J Physiol 252(21)F1167–Fl 174

    PubMed  CAS  Google Scholar 

  13. Norris CS, Barnes RW (1984) Renal artery flow velocity analysis: a sensitive measure of experimental and clinical renovascular restistance. J Surg Res 36: 230–236

    Article  PubMed  CAS  Google Scholar 

  14. Young DF (1979) Fluid mechanics of arterial stenosis. J Biomed Eng 101: 157–175

    Google Scholar 

  15. Jacobson HR (1988) Ischemic renal disease: an overlooked clinical entity? Kidney Int 34:729–743.

    Article  PubMed  CAS  Google Scholar 

  16. Textor SC, Novick AC, Tarazi RC, Klimas V, Vidt DG, Pohl M (1985) Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. Ann Intern Med 102: 308–314

    PubMed  CAS  Google Scholar 

  17. Raphael MJ, Donaldson RM (1989) A “significant” stenosis: thirty years on. Lancet 1:207–208.

    Article  PubMed  CAS  Google Scholar 

  18. Ferrario CM, McCubbin JW (1973) Renal blood flow and perfusion pressure before and after development of renal hypertension. Am J Physiol 224: 102

    PubMed  CAS  Google Scholar 

  19. Dzau VJ, Siwek LG, Rosen S, Farhi ER, Mizoguehi H, Barger AC (1981) Sequential renal hemodynamics in experimental benign and malignant hypertension. Hypertension 3: 63–68

    CAS  Google Scholar 

  20. Altobelli SA, Voyles WF, Greene ER (eds) (1985) Cardiovascular ultrasonic flowmetry. Elsevier, New York

    Google Scholar 

  21. Evans DH, McDicken WN, Skidmore R, Woodcock JP (1989) Doppler ultrasound: physics, instrumentation and clinical application. Wiley, New York.

    Google Scholar 

  22. Kremkau FW (1989) Review of diagnostic ultrasound principles, instrumentation, and exercises, 3rd edn. Saunders, Philadelphia

    Google Scholar 

  23. Miles RD, Menke JA, Bashiru M, Colliver JA (1987) Relationships of five Doppler measures with flow in an in vitro model and clinical findings in newborn infants. J Ultrasound Med 6: 597–599

    PubMed  CAS  Google Scholar 

  24. Phillips DJ, Beach KW, Primozich J, Strandness DE (1989) Should results of ultrasound Doppler studies be reported in units of frequency or velocity? Ultrasound Med Biol 15(3) 205–212.

    Article  PubMed  CAS  Google Scholar 

  25. Handa N, Fukunaga R, Etani H, Yoneda S, Kimura K, Kamada T (1988) Efficacy at echo- Doppler examination for the evaluation of renovascular disease. Ultrasound Med Biol 14 (1): 1–5

    Article  PubMed  CAS  Google Scholar 

  26. Greene ER, Avasthi PS, Hodges JW (1987) Noninvasive Doppler assessment of renal artery stenosis and hemodynamics. J Clin Ultrasound 15: 653–659

    Article  PubMed  CAS  Google Scholar 

  27. Norris CS, Pfeiffer JS, Rittgers SE, Barnes RW (1984) Noninvasive evaluation of renal artery stenosis and renovascular resistance. J Vase Surg 1 (1): 192–201

    Article  CAS  Google Scholar 

  28. Avasthi PS, Voyles WF, Greene ER (1984) Noninvasive diagnosis of renal artery stenosis by echo-Doppler velocimetry. Kidney Int 25: 824–829

    Article  PubMed  CAS  Google Scholar 

  29. Dubbins PA (1986) Renal artery stenosis: duplex Doppler evaluation. Br J Radiol 59: 225–229

    Article  PubMed  CAS  Google Scholar 

  30. Kohler TR, Zierler RE, Martin RL, Nicholls SC, Bergelin RO, Kazmers A, Beach KW, Strandness Jr DE (1986) Noninvasive diagnosis of renal artery stenosis by ultrasonic duplex scanning. J Vase Surg 4 (5): 450–456

    CAS  Google Scholar 

  31. Rittgers SE, Norris CS, Barnes RW (1985) Detection of renal artery stenosis: experimental and clinical analysis of velocity waveforms. Ultrasound Med Biol 11 (3): 523–531

    Article  PubMed  CAS  Google Scholar 

  32. Jenni R, Vieli A, Luscher TF, Schneider E, Vetter W, Anliker M (1986) Combined two- dimensional ultrasound Doppler technique: new possibilities for the screening of renovascular and parenchymatous hypertension. Nephron 44 (l): 2–4

    Article  PubMed  Google Scholar 

  33. Handa N, Fukanaga R, Ogawa S, Matsumoto M, Kimura K, Kamada T (1988) A new accurate and noninvasive screening method for renovascular hypertension: the renal artery Doppler technique. J Hypertens 6 (4): S458–S460

    CAS  Google Scholar 

  34. Tayler DC, Kettler MD, Moneta GL, Kohler TR, Kazmers A, Beach KW, Strandness DE (1988) Duplex ultrasound scanning in the diagnosis of renal artery stenosis: a prospective evaluation. J Vase Surg 7: 363–369

    Google Scholar 

  35. Robertson R, Murphy A, Dubbins PA (1988) Renal artery stenosis: the use of duplex ultrasound as a screening technique. Br J Radiol 61: 196–201

    Article  PubMed  CAS  Google Scholar 

  36. Rifkin MD, Pasto ME, Goldberg BB (1985) Duplex Doppler examination in renal disease: evaluation of vascular involvement. Ultrasound Med Biol 11 (2): 341–346

    Article  PubMed  CAS  Google Scholar 

  37. Handa N, Fukunaga R, Uehara A, Etani H, Yoneda S, Kimura K, Kamada T (1986) Echo- Doppler velocimeter in the diagnosis of hypertensive patients: the renal artery Doppler technique. Ultrasound Med Biol (12):945–952

    Article  PubMed  CAS  Google Scholar 

  38. Tayler DC, Moneta GL, Strandness DE (1989) Follow-up of renal artery stenosis by duplex ultrasound. J Vase Surg (9):410–415

    Article  Google Scholar 

  39. Eidt JF, Fry RE, Clagett GP, Fisher Jr DF, Alway C, Fry WJ (1988) Postoperative follow- up of renal artery reconstruction with duplex ultrasound. J Vase Surg 8: 667–673

    CAS  Google Scholar 

  40. Kohler T, Langlois Y, Roederer G (1985) Sources of variability in carotid duplex examination: a prospective study. Ultrasound Med Biol 11: 571

    Article  PubMed  CAS  Google Scholar 

  41. McDicken WN (1986) A versatile test-object for the calibration of ultrasonic Doppler flow instruments. Ultrasound Med Biol 12: 245–249

    Article  PubMed  CAS  Google Scholar 

  42. Gill RW (1985) Measurements of blood flow by ultrasound: accuracy and sources of error. Ultrasound Med Biol 11: 625

    Article  PubMed  CAS  Google Scholar 

  43. Voyles WF, Altobelli SA, Fisher DC et al. (1985) A comparison of digital and analog methods of Doppler spectral analysis for quantifying flow. Ultrasound Med Biol 11: 727–732

    Article  PubMed  CAS  Google Scholar 

  44. Walter JP, McGahn JP, Lantz BM (1986) Absolute flow measurements using pulsed Doppler ultrasound: work in progress: Radiology 159: 545–547

    PubMed  CAS  Google Scholar 

  45. Avasthi PS, Greene ER, Voyles WF, Eldridge MW (1984) A comparison of echo-Doppler and electromagnetic renal blood flow measurements. Ultrasound Med 3: 213–218

    PubMed  CAS  Google Scholar 

  46. Greene ER, Avasthi PS, Voyles WF, Seigel R (1986) Noninvasive venus invasive Doppler renal blood velocity and flow measurements. IEEE Trans Biomed Eng 33 (3): 302–307

    Article  PubMed  CAS  Google Scholar 

  47. Marcus ML, Hiratzka LF, Doty DB et al. (1986) Coronary obstructive lesions: assessing the physiological significance in humans. Ann Thorac Surg 42: S5–S11

    Article  PubMed  CAS  Google Scholar 

  48. Powers WJ, Press GA, Grubb RL et al. (1987) The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation. Ann Intern Med 106: 27–32

    PubMed  CAS  Google Scholar 

  49. Taylor KJW, Morse SS, Rigsby CM, Bia M, Schiff M (1987) Vascular complications in renal allografts: detection with duplex Doppler US. Radiology 162: 31–38

    PubMed  CAS  Google Scholar 

  50. Rigsby CM, Burns PN, Weltin GG, Chen B, Bia M, Taylor KJW (1987) Doppler signal quantitation in renal allografts: comparison in normal and rejecting transplants, with pathologic correlation. Radiology 162: 39–42

    PubMed  CAS  Google Scholar 

  51. Warshauer DM, Taylor KJW, Bia MJ, Marks WH, Weltin GG, Rigsby CM, True LD, Lorber MI (1988) Unusual causes of increased vascular impedance in renal transplants: duplex Doppler evaluation. Radiology 169: 367–370

    PubMed  CAS  Google Scholar 

  52. Murphy AM, Robertson RJ, Dubbins PA (1987) Duplex ultrasound in the assessment of renal transplant complications. Clin Radiol 38: 229–234

    Article  PubMed  CAS  Google Scholar 

  53. Fleischer AC, Hinton AA, Glick AD, Johnson HK (1989) Duplex Doppler sonography of renal transplants. J Ultrasound Med 8: 89–94

    PubMed  CAS  Google Scholar 

  54. Genkins SM, Sanfilippo FP, Carroll BA (1989) Duplex Doppler sonography of renal trans-plants: lack of sensitivity and specificity in establishing pathologic diagnosis. Am J Radiol 152: 535–539

    CAS  Google Scholar 

  55. Malfi B, Ferretti G, Messina M, Salomone A, Squiccimarro G, Colla L, Rossetti M, Triolo G, Segoloni GP, Vercellone A (1986) Echo-Doppler velocimetry in the diagnosis of renal artery stenosis on transplanted kidney. Clin Nephrol 26(4)181–184.

    PubMed  CAS  Google Scholar 

  56. Steinberg HV, Nelson RC, Murphy FB, Chezmar JL, Baumgartner BR, Delaney VB, Whelchel JD, Bernardino ME (1987) Renal allograft rejection: evaluation by Doppler US and MR imaging. Radiology 162: 337–342

    PubMed  CAS  Google Scholar 

  57. Piccirillo M, Taylor KJW, Flyles MW, Burns PN, True LD, Weltin G (1988) Investigation of Doppler waveforms in porcine renal allografts: Doppler-pathologic correlation. Ultrasound Med Biol 14 (2): 111–115

    Article  PubMed  CAS  Google Scholar 

  58. Rifkin MD, Needleman L, Pasto ME, Kurtz AB, Foy PM, McGlynn E, Canino C, Baltarowich OH, Pennell RG, Goldberg BB (1987) Evaluation of renal transplant rejection by duplex Doppler examination. Am J Radiol 148: 759–762

    CAS  Google Scholar 

  59. Schwaighofer B, Kainberger F, Fruehwald F, Huebsch P, Gritzmann N, Karnel F, Tscholakoff D (1988) Duplex sonography of normal renal allografts. Acta Radiol [Diagn] (Stockh) 30:53–56.

    Article  Google Scholar 

  60. Allen KS, Jorkasky DK, Arger PH, Velchik MG, Grumbach K, Coleman BG, Mintz MC, Betsch SE, Perloff LJ (1988) Renal allografts: prospective analysis of Doppler sonography. Radiology 169: 371–376

    PubMed  CAS  Google Scholar 

  61. Snider JF, Hunter DW, Morandian GP, Castaneda-Zuniga WR, Letourneau JG (1989) Transplant renal artery stenosis: evaluation with duplex sonography. Radiology 172: 1027–1030

    PubMed  CAS  Google Scholar 

  62. Vergesslich KA, Khoss AE, Balzar E, Schwaighofer B, Ponhold W (1988) Acute renal transplant rejection in children: assessment by duplex Doppler sonography. Pediatr Radiol 18: 474–478

    Article  PubMed  CAS  Google Scholar 

  63. Avasthi PS, Greene ER, Scholler C, Fowler CR (1983) Noninvasive diagnosis of renal vein thrombosis by ultrasonic echo-Doppler flowmetry. Kidney Int 23: 882–887

    Article  PubMed  CAS  Google Scholar 

  64. Kotval PS, Fakhry J, Khoury A, Barakat K (1989) Doppler flow signature of the left renal vein. 0Am J Radiol> 151: 202–203

    Google Scholar 

  65. Reuther G, Wanjura D, Bauer H (1989) Acute renal vein thrombosis in renal allografts: detection with duplex Doppler US. Radiology 170: 557–558

    PubMed  CAS  Google Scholar 

  66. Platt JF, Rubin JM, Ellis JH, DiPietro MA (1989) Duplex Doppler US of the kidney: differentiation of obstructive from nonobstructive dilatation. Radiology 171: 515–517

    PubMed  CAS  Google Scholar 

  67. Dubbins PA, Wells I (1986) Renal carcinoma: duplex Doppler evaluation. Br J Radiol 59:231–236.

    Article  PubMed  CAS  Google Scholar 

  68. Kuijpers D, Jaspers R (1989) Renal masses: differential diagnosis with pulsed Doppler US. Radiology 170: 59–60

    PubMed  CAS  Google Scholar 

  69. Hata T, Hata K, Aoki S, Takamiya O, Murao F, Kitao M (1987) Renal arterial blood flow velocity waveforms in pregnant women. Am J Obstet Gynecol 157: 1269–1271

    PubMed  CAS  Google Scholar 

  70. Stevens PE, Gwyther SJ, Boultbee JE, Bolsin S, Hanson ME, Kox W (1988) Practical use of duplex Doppler analysis of the renal vasculature in critically ill patients. Lancet 1: 240–242

    Google Scholar 

  71. Okuhn SP, Reilly LM, Bennett III JB, Hughes L, Goldstone J, Ehrenfeld WK, Stoney RJ (1987) Intraoperative assessment of renal and visceral artery reconstruction: the role of duplex scanning and spectral analysis. J Vase Surg 5: 137–147

    CAS  Google Scholar 

  72. Bomelburg T, Jorch G (1988) Investigations of renal artery blood flow velocity in preterm and term neonates by pulsed Doppler ultrasonography. Eur J Pediatr 147: 283–287

    Article  PubMed  CAS  Google Scholar 

  73. Wong SN, Lo RNS, Yu ECL (1988) Renal blood flow pattern by noninvasive Doppler ultrasound in normal children and acute renal failure patients. J Ultrasound Med 8: 135–141

    Google Scholar 

  74. Patriquin HB, O’Regan S, Robitaille P, Paltiel H (1989) Hemolytic-uremic syndrome: intrarenal arterial Doppler patterns as a useful guide to therapy. Radiology 172: 625–628

    PubMed  CAS  Google Scholar 

  75. Keller MS (1989) Renal Doppler sonography in infants and children. Radiology 172: 603–604

    PubMed  CAS  Google Scholar 

  76. Hoffmann U, Edwards GM, Carter S, Goldman ML, Harley JN, Zaccardi MG, Strandness DE (1991) Role fo duplex scanning for the detection of athersclerotic renal artery disease. Kidney Int 39: 1232–1239

    Article  PubMed  CAS  Google Scholar 

  77. Evens RG (1991) Doppler sonographic imaging of the vascular system. JAMA 265:2382–2387.

    Article  Google Scholar 

  78. Taylor D (1991) Duplex ultrasound in the assessment of vascular disease in clinical hypertension. AJH 4: 550–556

    PubMed  CAS  Google Scholar 

  79. Lamont AC, Hall HS, Thompson JR, Evan DH (1991) Doppler ultrasound studies in renal arteries of normal newborn babies. Brit J Radiol 64: 413–416

    Article  PubMed  CAS  Google Scholar 

  80. Kelcz F, Pozniak MA, Pirsch JW, Oberly TD (1990) Pyramidal appearance and resistance index: Insensitive and nonspecific sonographic indicators of renal transplant rejection. AJR 155: 531–535

    PubMed  CAS  Google Scholar 

  81. Meyer M, Panshter D, Steinmuller DR (1990) The use of duplex Doppler ultrasonography to evaluate renal allograft dysfunction. Transplantation 50: 974–978

    Article  PubMed  CAS  Google Scholar 

  82. Perchik JE, Baumgartner BR, Bernardino ME (1991) Renal transplant rejection: limited value of duplex Doppler sonography. Invest Radiol 26: 422–426

    Article  PubMed  CAS  Google Scholar 

  83. Sheikh KH, Davidson CJ, Newman GE, Kisslo KB, Schwab SJ (1991) Intravascular ultra-sound assessment of the renal artery. Annals Intern Med 115: 22–25

    CAS  Google Scholar 

  84. Yura T, Takamitsu Y, Yuasa S, Miki S, Takahashi N, Bandai H, Sumikura T, Uchida K, Tamai T, Matsuo H (1991) Total and split renal function assessed by ultrasound Doppler techniques. Nephron 58: 37–41

    Article  PubMed  CAS  Google Scholar 

  85. Piatt JF, Ellis JH, Rubin JM (1991) Examination of native kidneys with duplex Doppler ultrasound. Sem Ultrasound CT MR 12: 308–318

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Verlag, Berlin Heidelberg

About this paper

Cite this paper

Avasthi, P.S., Tawney, K.W., Greene, E.R. (1992). Noninvasive Assessment of Human Renal Blood Flow by Ultrasonic Doppler Flowmetry. In: Lüscher, T.F., Kaplan, N.M. (eds) Renovascular and Renal Parenchymatous Hypertension. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-61239-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-61239-8_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64756-7

  • Online ISBN: 978-3-642-61239-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics