[超声造影及数字减影血管造影对肾动脉狭窄的诊断价值]
[Diagnostic value of contrast-enhanced sonography and digital subtraction angiography for renal artery stenosis].
作者信息
Ren J H, Ma N, Wang S Y, Sun Y J, Zhang Y W, Ma W H, Guo F J
机构信息
Department of Sonography, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2019 Jan 15;99(3):209-211. doi: 10.3760/cma.j.issn.0376-2491.2019.03.011.
To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) and digital subtraction angiography (DSA) for renal artery stenosis (RAS). Fifty-seven hypertensive patients suspected for RAS admitted in Beijing Hospital from September 2017 to August 2018 were enrolled. All 114 renal arteries were assessed by CEUS and DSA. RAS was subdivided into low-(30%-50%), moderate-(50%-69%) and high-grade (70%-99%) subgroups. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were compared between CEUS and DSA results. Fifty-seven hypertensive patients (31 males, mean age 57.1 years) involving 114 renal arteries were included. Overall, DSA identified RAS in 71(62.3%) renal arteries, mild RAS, 34(29.8%); moderate RAS, 23(20.2%); severe RAS, 14(12.3%). With CEUS, the sensitivity, specificity, accuracy, PPV and NPV for detecting mild-grade RAS were 85.3%, 97.3%, 91.5%, 96.7% and 87.8%; for detecting moderate-grade RAS were 82.6%, 97.9%, 92.9%, 95.0% and 92.2%; for detecting high-grade RAS were 85.7%, 98.2%, 95.8%, 92.3% and 96.5%. The measure of agreement was 0.92 between CEUS and DSA. CEUS is a safe and accurate method for the diagnosis and severity classification of RAS, especially those with kidney injury.
评估超声造影（CEUS）和数字减影血管造影（DSA）对肾动脉狭窄（RAS）的诊断价值。纳入2017年9月至2018年8月在北京医院收治的57例疑似RAS的高血压患者。对所有114条肾动脉进行了CEUS和DSA评估。RAS分为低级别（30%-50%）、中级别（50%-69%）和高级别（70%-99%）亚组。比较了CEUS和DSA结果之间的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。纳入了57例高血压患者（31例男性，平均年龄57.1岁），涉及114条肾动脉。总体而言，DSA在71条（62.3%）肾动脉中发现了RAS，轻度RAS 34条（29.8%）；中度RAS 23条（20.2%）；重度RAS 14条（12.3%）。对于CEUS，检测轻度RAS的敏感性、特异性、准确性、PPV和NPV分别为85.3%、97.3%、91.5%、96.7%和87.8%；检测中度RAS的分别为82.6%、97.9%、92.9%、95.0%和92.2%；检测高级别RAS的分别为85.7%、98.2%、95.8%、92.3%和96.5%。CEUS和DSA之间的一致性度量为0.92。CEUS是一种安全、准确的诊断RAS及其严重程度分级的方法，尤其是对于伴有肾损伤的患者。
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