Solar Miroslav, Zizka Jan, Krajina Antonín, Michl Antonín, Raupach Jan, Klzo Ludovit, Ryska Pavel, Ceral Jirí
Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Czech Republic.
Acta Medica (Hradec Kralove). 2011;54(1):9-12. doi: 10.14712/18059694.2016.10.
The aim of our study was to evaluate duplex ultrasonography (DUS) and magnetic resonance angiography (MRA) in detection of haemodynamically significant renal artery stenosis (RAS).
The study included patients with high clinical suspicion of renovascular hypertension (RVH). The imaging of renal arteries was performed by DUS, MRA and digital subtraction angiography (DSA). Significant RAS was defined as maximum systolic velocity > or =180 cm/sec (DUS) or as 60% reduction of the endoluminal arterial diameter (MRA, DSA). The results of DUS and MRA were assessed in respect to the results of DSA.
Arterial supply of 186 kidneys in 94 patients was evaluated. DSA revealed significant RAS in 61 kidneys evaluated. DUS was not able to examine arterial supply in 18 kidneys of 13 patients. In the detection of significant RAS, DUS was characterized by sensitivity and specificity of 85% and 84%. MRA achieved satisfactory imaging quality in all but one kidney evaluated. The sensitivity and specificity of MRA in the detection of significant RAS was 93% and 93%, respectively.
In patients with high clinical probability of RVH, MRA proved to be more reliable and superior in both sensitivity and specificity to DUS in the detection of significant RAS.
我们研究的目的是评估双功超声（DUS）和磁共振血管造影（MRA）在检测具有血流动力学意义的肾动脉狭窄（RAS）中的作用。
该研究纳入了临床高度怀疑肾血管性高血压（RVH）的患者。通过DUS、MRA和数字减影血管造影（DSA）对肾动脉进行成像。显著RAS定义为最大收缩速度≥180厘米/秒（DUS）或管腔内动脉直径减少60%（MRA、DSA）。根据DSA的结果评估DUS和MRA的结果。
对94例患者的186个肾脏的动脉供应情况进行了评估。DSA显示在评估的61个肾脏中存在显著RAS。DUS无法检查13例患者中18个肾脏的动脉供应情况。在检测显著RAS方面，DUS的敏感性和特异性分别为85%和84%。除一个肾脏外，MRA在所有评估的肾脏中均获得了满意的成像质量。MRA检测显著RAS的敏感性和特异性分别为93%和93%。
在临床高度怀疑RVH的患者中，在检测显著RAS方面，MRA在敏感性和特异性上均被证明比DUS更可靠且更具优势。
