动态增强磁共振血管造影和螺旋CT血管造影诊断肾动脉狭窄的比较

Comparison of renal artery stenosis diagnosis by dynamic contrast enhanced magnetic resonance angiography and spiral computed tomography angiography

目的比较三维动态增强磁共振血管造影（DCE—MRA）与螺旋CT血管造影（SCTA）对肾动脉狭窄检查的价值。方法对进行肾动脉狭窄检查的50例患者同时行DCE—MRA与SCTA检查，其中证实有狭窄的25例患者再行数字减影血管造影（DSA）检查。然后以DSA为标准，评价这两种检查方法。结果50例患者的100根肾动脉，DCE—MRA与SCTA诊断的K系数为0．831，诊断一致性好。CE—MRA诊断的敏感性为96．0％，特异性为94．0％，阳性预测值为91．8％，阴性预测值为98．0％；SCTA诊断的敏感性为96．8％，特异性为95．7％，阳性预测值为93．4％，阴性预测值为96．7％。DCE—MRA在肾动脉狭窄诊断上的敏感性、特异性、阳性预测值、阴性预测值要略低于SCTA。结论DCE—MRA与CTA都能较准确地诊断肾动脉狭窄，但DCE—MRA更安全。

Objective To evaluate the value of three dimensional dynamic contrast enhanced magnetic resonance angiography（DCE-MRA） and spiral CT angiography （SCTA） in the diagnosis of renal artery stenosis （RAS）. Methods Fifty patients suspected of RAS were performed with both DCE-MRA and SCTA, and 25 patients confirmed with RAS were performed with DSA. Results DCE-MRA and SCTA in evaluation of RAS had the kappa coefficient of 0.831. In the diagnosis RAS, the sensitivity, specificity, positive and predictive value and negative predictive value of DCF-MRA （96.0% , 94.0% , 91.8% , 98.0% ） were slightly lower than those of SCTA（96.8% , 95.7%, 93.4%, 96.7% ）. Conclusions DCE-MRA and CTA can accurately diagnose renal artery stenosis. ACE- MRA is more safe and more appropriate for the diagnosis of the RAS compared with DCE-MRA.