比较CT联合MRI与传统DSA诊断肾动脉狭窄性高血压的临床差异及应用价值

The Comparative Study on the Clinical Differences and Application Value of CT with MRI and Conventional DSA in the Diagnosis of Renovascular Hypertension

目的 比较CT联合磁共振成像（MRI）与传统数字减影血管造影（DSA）诊断肾动脉狭窄性高血压的临床效果,分析其临床应用价值.方法 选取2012年1月至2013年1月上海中山医院青浦分院检查的高血压患者220例为研究对象,分别行超声CT检查以及MRI检查,联合两项检查结果与传统的“金标准”DSA检查结果进行比较.结果 CT联合MRI检查出肾动脉狭窄性共87条,与DSA检查结果相比,灵敏度为100％（81/81）,特异度为98.5％（394/400）,阳性预测值为93.1％（81/87）,阴性预测值为100（394/394）,与DSA检查结果有较好的一致性（K=0.96,95％CI0.92-0.99）.在显示各级肾动脉狭窄方面,CT联合MRI与DSA比较一致性较高（K=0.97,95％ CI0.94-0.97）.结论 CT联合MRI在检查肾动脉狭窄性高血压方面与DSA检查的一致性较高,具有一定的临床诊断价值.

Objective To compare the clinical value of CT combined with magnetic resonance imaging （MRI） and conventional digital subtraction angiography（DSA） in the diagnosis of renal artery stenosis hypertension,and to analyze its clinical application value.Methods A total of 220 patients inspected with hypertensionin Qingpu Branch of Shanghai Zhongshan Hospital from Jan.2012 to Jan.2013 were selected as the objects of the study.Ultrasonic CT scan and MRI were performed for examination,and the combined two test results were compared with the traditional ＂ gold standard＂ DSA examination results.Results There were 87 cases of renal artery stenosis were diagnosedby CT combined with MRI,compared with the findings of DSA,the sensitivity rate was 100 ％ （81/81）,the specificity was 98.5 ％ （394/400）,the positive predictive value was 93.1％ （81/87）,the negative predictive value was 100 （394/394）,which were well consistent with the DSA results（K =0.96,95 ％ CI 0.92-0.99）.In the display levels of renal artery stenosis,CT combined with MRI and DSA had relatively high consistency（K =0.97,95％ CI0.94-0.97）.Conclusion CT combined with MRI is with high consistency in the examination of renal artery stenosis in hypertension with DSA examination,and has a certain diagnostic value.