Hortling N, Strunk H, Wilhelm K, Hofer U, Schild H H
Radiologische Kinik, Universität Bonn.
Rofo. 1998 Oct;169(4):397-401. doi: 10.1055/s-2007-1015306.
To assess whether the use of an echo-enhancing agent reliably allows the diagnosis of renal artery stenosis with colour-coded Doppler sonography.
We examined the main, segmental, and, if present, the accessory renal arteries of 31 patients before and after intravenous injection of Levovist using colour-coded Doppler sonography and compared the results with digital subtraction angiography. A rise in peak systolic velocity in the main renal artery and a reduction of the acceleration index in segmental arteries were used as parameters to detect renal artery stenosis.
After i.v. administration of Levovist the main stem of the renal arteries could be well delineated in 36 of 62 cases (58%) during colour-coded Doppler sonography against 31 cases without Levovist. Taking only the visible cases in account the sensitivity of native as well as of enhanced colour-coded Doppler sonography of the renal main stem was 100%, the specificity was 96% and 94%, respectively. Only one of 11 accessory renal arteries was identified after echo enhancement. The segmental arteries were seen only after echo enhancement in 12 cases so that 60 of the total of 62 renal arteries (95%) could be evaluated. The sensitivity and specificity of the native examination were 67% and 70%. After echo enhancement sensitivity was 75% and specificity was 81%.
Using an echo-enhancing agent the sensitivity and specificity for detection of relevant renal artery stenosis could only be slightly improved compared to the native examination.
评估使用回声增强剂是否能通过彩色编码多普勒超声可靠地诊断肾动脉狭窄。
我们在31例患者静脉注射Levovist前后，使用彩色编码多普勒超声检查其主要肾动脉、节段性肾动脉以及（如有）副肾动脉，并将结果与数字减影血管造影进行比较。将主肾动脉收缩期峰值速度升高和节段性动脉加速度指数降低作为检测肾动脉狭窄的参数。
静脉注射Levovist后，在62例中的36例（58%）彩色编码多普勒超声检查中，肾动脉主干能够清晰显示，而未使用Levovist的情况下为31例。仅考虑可见病例，肾动脉主干的未增强及增强彩色编码多普勒超声检查的敏感性均为100%，特异性分别为96%和94%。回声增强后仅识别出11条副肾动脉中的1条。12例中节段性动脉仅在回声增强后可见，因此62条肾动脉中的60条（95%）能够被评估。未增强检查的敏感性和特异性分别为67%和70%。回声增强后敏感性为75%，特异性为81%。
与未增强检查相比，使用回声增强剂检测相关肾动脉狭窄的敏感性和特异性仅略有提高。
