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

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。

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

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.