多普勒超声对肾动脉狭窄的筛查诊断价值

Diagnostic Value of Doppler Ultrasonography in Screening Renal Artery Stenosis

目的:评价彩色多普勒和频谱多普勒超声对肾动脉狭窄的筛查诊断价值。方法:应用彩色多普勒和频谱多普勒超声分别测量17例肾动脉狭窄患者的33支肾动脉(其中21支肾动脉狭窄)和18例无肾动脉狭窄的高血压病患者的36支肾动脉的主干峰值流速(Vmax)、肾动脉与腹主动脉峰值流速比值(RAR)和肾脏大小,并与肾动脉造影或CTA结果进行对比分析。结果:17例肾动脉狭窄患者的21支肾动脉Vmax≥180cm/s,RAR≥1.5,并且Vmax、RAR与肾动脉狭窄程度呈正相关;以Vmax≥210cm/s诊断狭窄率≥50%的肾动脉狭窄,敏感性为88%,特异性为75%,诊断准确性为86%。结论:多普勒超声可以准确诊断肾动脉狭窄,并可判断狭窄程度,可以作为高血压病患者有无肾动脉狭窄的筛查诊断方法。

Objective： To evaluate the diagnostic value of color Doppler flow imaging and pulsed Doppler ultrasonography in screening renal artery stenosis （RAS）. Methods： .Thirty three branches of renal artery in 17 patients with RAS and 36 branches of renal artery in 18 hypertensive subjects without RAS were enrolled in the study. The peak systolic velocity of renal artery （Vmax）, the ratio of peak systolic velocity of renal artery and abdominal aorta （RAR） and the size of kidney was measured by color Doppler flow imaging and pulsed Doppler ultrasonography and compared with angiography or CTA. Results： Twenty one branches of renal artery in 17 patients showed Vmax≥ 180 cm/s, RAR≥1.5 and there were significantly positive correlations between Vmax, RAR and degree of RAS de termined by renal artery angiography or CTA. The sensitivity, specificity and accuracy of Vmax≥210 cm/s were 88%, 75% and 86% for patients with RAS≥50%, respectively. Conclusions： Doppler ultrasonography can not only be used to diagnose RAS accurately, but also to estimate the degree of stenosis, and it might be a diagnostic method in screening RAS in patients with hypertension.