el-Azab M, Mohsen T, el-Diasty T, Shokeir A A
Urology and Nephrology Center, Mansoura University, Egypt.
J Urol. 1996 Sep;156(3):878-80.
We compared the accuracy of Doppler ultrasonography and intra-arterial digital subtraction angiography for preoperative visualization of the number of renal arteries in potential live kidney donors.
Intra-arterial digital subtraction angiography and Doppler ultrasonography were used to study the renal anatomy of 64 consecutive kidney donors. Doppler studies were performed without knowledge of the angiographic findings. All donors underwent nephrectomy, and the number of renal arteries at nephrectomy was compared with that predicted by intra-arterial digital subtraction angiography and Doppler ultrasonography.
One renal artery was found in 53 harvested kidneys, 2 in 10 and 3 in only 1. Analysis of the data revealed sensitivity 96.2% and specificity 100% for intra-arterial digital subtraction angiography versus sensitivity 100% and specificity 60% for Doppler ultrasound. Overall accuracy was 96.8% for angiography versus 93.7% for Doppler ultrasound, compared to 96.2 and 100%, respectively, for single, and 100% and 60%, respectively, for double renal arteries (p < 0.03). Both tests were interpreted as showing double vessels in the case with triple renal arteries.
Although Doppler ultrasonography is accurate in delineation of single renal arteries, its limited ability to identify multiple arteries should make one cautiously optimistic regarding its current use.
我们比较了多普勒超声检查和动脉内数字减影血管造影术在术前评估潜在活体肾供体肾动脉数量的准确性。
采用动脉内数字减影血管造影术和多普勒超声检查对64例连续的肾供体的肾脏解剖结构进行研究。在不知道血管造影结果的情况下进行多普勒检查。所有供体均接受了肾切除术,并将肾切除术中发现的肾动脉数量与动脉内数字减影血管造影术和多普勒超声检查预测的数量进行比较。
在53个切除的肾脏中发现1条肾动脉,10个中发现2条,仅1个中发现3条。数据分析显示,动脉内数字减影血管造影术的敏感性为96.2%,特异性为100%;而多普勒超声的敏感性为100%,特异性为60%。血管造影术的总体准确率为96.8%,多普勒超声为93.7%;单条肾动脉的准确率分别为96.2%和100%,双条肾动脉的准确率分别为100%和60%(p < 0.03)。在有三条肾动脉的病例中,两种检查均被解读为显示有两条血管。
尽管多普勒超声检查在描绘单条肾动脉方面是准确的,但其识别多条动脉的能力有限,这使得人们对其目前的应用应持谨慎乐观的态度。