Taylor A
Division of Nuclear Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Semin Nephrol. 2000 Sep;20(5):437-44.
Angiotensin-converting enzyme inhibition (ACEI) renography is the only imaging examination that tests directly for the presence of renovascular hypertension (RVH); other imaging examinations test only for the presence of renal artery stenosis (RAS). Consensus panels have recommended that ACEI renograms be interpreted as low, intermediate, or high probability for RVH. ACEI renography is highly accurate in patients with normal renal function and suspected RVH. In this patient population, the sensitivity and specificity of ACEI renography for RAS are approximately 90%; as an initial approach, angiography is not cost effective. Data from 10 studies evaluating cure or improvement in blood pressure in 291 patients undergoing revascularization showed the mean positive predictive value of ACEI renography to be 92%. When azotemic patients present with suspected RVH, as many as 50% of patients may have an intermediate probability ACEI renogram and the sensitivity of detecting RVH falls to approximately 80% even when intermediate and high probability tests are combined.
血管紧张素转换酶抑制（ACEI）肾图检查是唯一直接检测肾血管性高血压（RVH）是否存在的影像学检查；其他影像学检查仅检测肾动脉狭窄（RAS）是否存在。共识小组建议将ACEI肾图解读为RVH的低、中或高概率。ACEI肾图对肾功能正常且疑似RVH的患者具有高度准确性。在这一患者群体中，ACEI肾图对RAS的敏感性和特异性约为90%；作为初始检查方法，血管造影术不具有成本效益。对291例接受血运重建的患者进行血压治愈或改善评估的10项研究数据显示，ACEI肾图的平均阳性预测值为92%。当氮质血症患者出现疑似RVH时，多达50%的患者可能有中等概率的ACEI肾图，即使将中等概率和高概率检查结合起来，检测RVH的敏感性也会降至约80%。
