Liu K, Chen J, Peng Y, He S, Chen X
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Herz. 2013 Aug;38(5):549-52. doi: 10.1007/s00059-012-3723-9. Epub 2013 Jan 23.
Renovascular hypertension (RVH) is a common cause of secondary hypertension. Noninvasive tests such as computed tomography angiography (CTA) or magnetic resonance angiography have a high specificity and sensitivity for the diagnosis. Digital subtraction angiography (DSA) is, however, the gold standard with which RVH can be reliably diagnosed. We report the case of a 30-year-old Chinese man with right ureter malformation and stenosis of the entire right renal artery. We discuss how to distinguish between inconsistencies in CTA results and DSA findings. Interobserver variability is an important factor that leads to such inconsistencies and cannot be ignored. Importantly, clinicians should combine imaging findings with the patient's medical history and clinical manifestations rather than blindly believing the DSA results so as to avoid unnecessary medical disputes.
肾血管性高血压（RVH）是继发性高血压的常见病因。计算机断层血管造影（CTA）或磁共振血管造影等非侵入性检查对其诊断具有较高的特异性和敏感性。然而，数字减影血管造影（DSA）是能够可靠诊断RVH的金标准。我们报告了一例30岁中国男性患者，其患有右侧输尿管畸形及整个右肾动脉狭窄。我们讨论了如何区分CTA结果与DSA检查结果之间的不一致性。观察者间差异是导致这种不一致性的一个重要因素，不容忽视。重要的是，临床医生应将影像学检查结果与患者的病史和临床表现相结合，而不是盲目相信DSA结果，以免引发不必要的医疗纠纷。
