Gottlieb R H, Lieberman J L, Ghaed V N, Grossman E B, Waldman D L, Azodo M V, Watt G H, Robinette W B, Carson N L
Department of Radiology, University of Rochester Medical Center, NY 14642-8648, USA.
Acad Radiol. 1996 Jan;3(1):57-62. doi: 10.1016/S1076-6332(96)80335-7.
We assessed the usefulness of the resistive index (RI) and renal length in predicting a significant renal artery stenosis (RAS) and evaluated the effect of captopril on the RI in kidneys with and without a significant RAS.
The RIs and renal lengths of both kidneys were measured in 39 patients who were referred for captopril renography for suspected renovascular hypertension. The difference in RIs (delta RI), the smaller RI (SRI), the difference in lengths (delta L), and the shorter length (SL) of the patient's two kidneys were determined. The accuracy of each of these parameters was calculated using captopril renography (n = 39) and arteriography (n = 9) as the gold standards.
There was a significant difference in the delta RI (P < .05), SRI (p < .001), and delta L (p < .05) in patients with a positive captopril renogram for a significant RAS. Captopril increased delta RI (p = .052) in patients with a positive captopril renogram (n = 6). Use of an SRI threshold of less than .55 resulted in ultrasound being as accurate as captopril renography in predicting an angiographically documented stenosis of greater than or equal to 50%.
The RI and renal length are useful in detecting a significant RAS. In this preliminary study, captopril was shown to increase delta RI in patients with a significant RAS, but larger prospective studies are necessary to further assess the value of captopril sonography in detecting a significant RAS.
我们评估了阻力指数（RI）和肾长度在预测显著肾动脉狭窄（RAS）方面的效用，并评估了卡托普利对存在和不存在显著RAS的肾脏中RI的影响。
对39例因疑似肾血管性高血压而接受卡托普利肾图检查的患者测量了双肾的RI和肾长度。确定了患者双肾的RI差值（δRI）、较小的RI（SRI）、长度差值（δL）和较短的长度（SL）。以卡托普利肾图检查（n = 39）和血管造影（n = 9）作为金标准，计算了这些参数各自的准确性。
卡托普利肾图检查显示存在显著RAS的患者，其δRI（P < .05）、SRI（P < .001）和δL（P < .05）存在显著差异。卡托普利使卡托普利肾图检查阳性的患者（n = 6）的δRI增加（P = .052）。使用小于0.55的SRI阈值，超声在预测血管造影证实的狭窄大于或等于50%方面与卡托普利肾图检查一样准确。
RI和肾长度在检测显著RAS方面有用。在这项初步研究中，卡托普利被证明可使存在显著RAS的患者的δRI增加，但需要更大规模的前瞻性研究来进一步评估卡托普利超声检查在检测显著RAS方面的价值。
