经颅多普勒检测糖尿病患者脑血流动力学变化

目的探讨2型糖尿病患者脑动脉血流动力学的变化.方法应用经颅多普勒超声（TCD）检测103例2型糖尿病患者脑动脉平均血流速度、血流频谱形态、搏动指数、血流速度异常动脉分布情况,并与103例健康者进行比较.结果两组受检动脉均为1 133支,糖尿病组脑内动脉血流速度异常102支,异常率为9.0%;103例患者中血流频谱形态异常83例,占80.6%;46例搏动指数增高,占44.7%,与对照组的3.1%、44.7%及18.4%比较,差异有显著性（P＜0.05）;血流速度减慢的受累动脉以椎-基底动脉为主,血流速度增快和血管狭窄较少见于大脑后动脉.结论TCD检查可为临床2型糖尿病患者脑血管疾病的防治提供依据.     

脑干梗死的相关危险因素及血管病变分析

目的探讨脑干梗死的危险因素及血管病变。方法选取2007年2月—2011年8月在我院住院治疗的急性脑梗死患者377例,根据颅脑MRI结果,将患者分为脑干梗死组(延髓、脑桥及中脑)和非脑干梗死组,比较两组的卒中危险因素;根据颅脑CE-MRA结果分析脑干梗死患者椎基底动脉血管病变。结果 (1)脑干梗死组糖尿病、糖耐量异常率及三酰甘油(TG)水平高于非脑干梗死组,差异有统计学意义(P<0.05);(2)脑干梗死患者椎基底动脉无狭窄者37例(37.7%),轻度狭窄者19例(19.3%),中重度狭窄者42例(43.0%)。7例中脑梗死中椎基底动脉狭窄者6例(85.7%),79例脑桥梗死中椎基底动脉狭窄者44例(55.7%),12例延髓梗死中椎基底动脉狭窄者11例(91.7%)。结论脑干梗死的危险因素不同于非脑干梗死,糖尿病、糖耐量异常及高TG多见于脑干梗死;脑干梗死多伴有椎基底动脉狭窄,脑干梗死最常见的发病机制是动脉粥样硬化。     

经颅超声多普勒对非典型眩晕脑底后循环检测的探讨

用经颅超声多普勒（ＴＣＤ）技术，对７０例非典型眩晕病人脑底后循环的椎－基底动脉系统检测，７２．８６％患者平均血流速度明显异常。４５．７１％患者基底动脉流速异常；６５．７１％出现椎动脉颅内段流速异常；６１．４３％小脑后下动脉流速异常。表现为流速减慢２４人，流速增高１９人，混合性异常８人。直线回归分析上述动脉血流速度与年龄呈负相关。中青年主要出现血管痉挛型的血流速度增高改变。老年组两种血流动力学异常的发生率均较高，以血管狭窄改变为主。     

椎基底动脉系统缺血患者数字减影血管造影检查结果分析

目的分析椎基底动脉缺血患者数字减影血管造影(DSA)检查结果。方法选择2009—2013年六安市人民医院神经内科收治的头晕患者62例,均进行颅脑DSA检查,分析其检查结果。结果 DSA检查发现血管异常24例(38.7%),其中前循环系统异常11例、后循环系统异常9例、前后循环系统均异常4例。椎动脉异常扭曲及纤细或发育异常37例(59.7%),椎动脉结构及起源均未见明显异常1例(1.6%)。结论血管异常、结构异常是椎基底动脉系统缺血的常见病因,血管异常是椎基底动脉缺血的结构基础,其前循环系统血管结构异常是椎基底动脉缺血的主要原因,其病因多样,并非完全由血管狭窄导致。     

灯盏细辛注射液治疗椎-基底动脉供血不足性眩晕80例疗效观察

目的观观察灯盏细辛注射液对椎-基底动脉供血不足性眩晕患者的治疗效果。方法将140例椎-基底动脉供血不足的患者随机分为两组,治疗组80例用灯盏细辛注射液治疗,对照组60例用香丹注射液治疗。治疗前后观察临床疗效、血液流变学参数及椎-基底动脉血流速度变化。结果治疗组总有效率为87.5%,对照组总有效率为63.33%。治疗组总有效率、血液流变学多项指标及椎基底动脉血流速度变化均优于对照组(P0.05)。结论灯盏细辛注射液是治疗椎-基底动脉供血不足安全有效的药物。     

眩晕宁片治疗椎-基底动脉供血不足性眩晕临床观察

目的 观察眩晕宁片治疗椎-基底动脉供血不足性眩晕的临床疗效及其对血流动力学的影响.方法 将132例椎-基底动脉供血不足性眩晕患者随机分为眩晕宁片治疗组和氟桂利嗪对照组,各66例,分别观察其临床疗效和治疗前后椎-基底动脉的平均血流速度(Vm)和脉动指数(PI).结果 治疗后两组总有效率间差异有统计学意义(P<0.05);两组治疗后较本组治疗前椎动脉和基底动脉的Vm、PI值差异均有统计学意义(P<0.05);治疗后两组患者上述指标间差异有统计学意义(P<0.05).结论 眩晕宁片对椎-基底动脉供血不足性眩晕有显著疗效,且无副作用.     

盐酸曲美他嗪辅助治疗椎-基底动脉供血不足性眩晕疗效观察

目的观察盐酸曲美他嗪辅助治疗椎-基底动脉供血不足性眩晕的效果。方法97例椎-基底动脉供血不足引发眩晕的患者随机分为2组,对照组给予盐酸倍他司汀治疗,治疗组给予盐酸倍他司汀联合盐酸曲美他嗪口服治疗,观察所有患者治疗14d后临床疗效及椎-基底动脉血流速度、阻力指数变化。结果治疗组总有效率优于对照组,治疗后两组患者椎-基底动脉血液流速、阻力指数较治疗前均明显改善,两组间比较无统计学差异。结论盐酸曲美他嗪辅助治疗椎-基底动脉供血不足引起的眩晕疗效显著,且不依赖于血流动力学的改变。     

经颅多普勒超声在椎-基底动脉缺血性眩晕中的应用价值

目的探讨经颅多普勒超声(TCD)在椎-基底动脉缺血性眩晕中的应用价值,以丰富临床诊治经验。方法选择我院2011年11月—2013年10月收治的椎-基底动脉缺血性眩晕患者110例,随机分为对照组和观察组,每组55例。两组患者分别于治疗前后进行TCD检查,对照组患者接受常规治疗,观察组患者在常规治疗基础上应用甘露醇联合地塞米松治疗;两组患者均连续治疗1周。观察两组患者临床疗效、治疗前后椎动脉和基底动脉血流速度及不良反应情况。结果观察组患者总有效率为90.9%,高于对照组的74.5%(χ2=5.153,P=0.023)。两组患者治疗前椎动脉和基底动脉血流速度比较,差异均无统计学意义(P0.05);观察组患者治疗后椎动脉和基底动脉血流速度均大于对照组(P0.05)。治疗期间两组患者共出现8例轻微恶心呕吐,7例皮疹,均经对症治疗后消失。结论TCD在椎-基底动脉缺血性眩晕的诊断和治疗中具有较高的临床应用价值,可行性较好;在常规治疗基础上联合应用甘露醇和地塞米松治疗椎-基底动脉缺血性眩晕疗效确切,有助于改善患者症状和体征。     

症状性脑供血动脉狭窄与阻塞性睡眠呼吸暂停低通气综合征的相关性研究

目的 探讨不同部位脑供血动脉狭窄与OSAHS之间的关系.方法 选取131例经全脑数字减影血管造影(DSA)证实的症状性脑供血动脉狭窄患者,将其按不同的狭窄部位分为3组:颈内动脉系统血管狭窄组(A组);椎基底动脉系统血管狭窄(B组);颈内-椎基底动脉系统血管狭窄组(C组).入选患者进行多导睡眠图监测,对所得数据进行比较分析.结果 131例脑供血动脉狭窄患者中并发OSAHS者高达106例(81％),3组间OSAHS发生率无明显差别,但B、C组呼吸暂停低通气指数(AHI)和平均氧减指数(AODI)均高于A组,且C组呼吸暂停事件次数与A组相比较多.结论 症状性脑供血动脉狭窄患者具有较高的SAHS患病率;不同部位的血管狭窄与SAHS患病率之间无显著性差异,但其中椎基底动脉狭窄、颈内-椎基底动脉合并狭窄的患者SAHS程度更重,在后者中更易出现多种类型的睡眠呼吸暂停事件.     

痰瘀同治法在椎-基底动脉供血不足中的应用

目的观察痰瘀同治法治疗椎-基底动脉供血不足的临床疗效,并探讨其作用机制.方法给50例椎-基底动脉供血不足病人口服痰瘀同治组方"三降汤",每日1剂,14 d为1个疗程.通过经颅多普勒超声(TCD)观察其用药前后椎-基底动脉系统供血情况.结果 50例椎-基底动脉供血不足病人临床症状基本消失或完全消失44例(88%),有改善6例(12%).TCD显示血流速度变化显著,血流缓慢组用药后3支动脉各项数值均较用药前有较大幅度提高(P＜0.01),血管狭窄组用药后过高的血流速度数值较用药前有所下降(P＜0.05).结论痰瘀同治法组方"三降汤"可改善椎-基底动脉供血不足的症状.     

Hypertension attenuates the efficacy of hypoglycemic therapy for preserving coronary flow reserve in patients with type 2 diabetes.

Impairment of coronary flow reserve (CFR) in patients with type 2 diabetes has been generally demonstrated; however, there have been few studies investigating CFR in cases of relatively well-controlled diabetes, in distinction to the influence of hypertension. The purpose of the present study was to evaluate the influence of diabetes and hypertension upon CFR in relatively well-controlled patients. This study included 12 healthy controls (C group) and 57 patients with type 2 diabetes (DM) and/or essential hypertension who were divided into three groups as follows: patients with DM (DM group; n = 24), patients with essential hypertension (HT group; n = 15), and patients with both DM and essential hypertension (DM+HT group; n = 18). We excluded patients with evidence of coronary artery disease and/or left ventricular hypertrophy. We performed transthoracic Doppler recording of diastolic coronary flow velocity (CFV) in the left anterior descending coronary artery at rest and after maximal vasodilation by adenosine infusion (140 microg/kg/min for 3 min) CFR was defined as the ratio of hyperemic to averaged basal peak CFV. The CFR (2.92 +/- 0.46) of the DM group was not decreased compared to that of the C group (2.96 +/- 0.58), although the CFR of the HT (2.33 +/- 0.25) and DM+HT (2.35 +/- 0.25) groups were significantly reduced. Left ventricular mass index, relative wall thickness, and diastolic function were worse in the HT and DM+HT groups than in the C and DM groups. Subjects with concentric left ventricular remodeling had a lower CFR than those with normal left ventricular geometry. In conclusion, adequate hyperglycemic control prevented the progression of coronary microcirculatory disturbance, but concomitant hypertension attenuated the effect.     

Postural vertigo and basilar artery flow increment

PURPOSE: Research was focused on cerebral arterial flow in normal individuals and in patients suffering from short-term vertigo when sitting up rapidly from a lying position. PATIENTS AND METHODS: The research was performed in normal subjects and 46 patients affected by short term vertigo who underwent transcranial Doppler 32. In normal subjects (16 with an average age of 25 and 16 with an average age of 61) cerebral artery flow was recorded in a sitting and lying position, in Trendelenburg position and during transition from one position to another. In subjects suffering from short-term vertigo, arterial flow was recorded at baseline and during short-term vertigo. RESULTS: In normal subjects the flow remained unchanged in all body positions as well as during transition from one position to another. In subjects with short-term vertigo basilar artery flow increased with the onset of dizziness and returned to normal when dizziness ceased. CONCLUSIONS: In normal subjects cerebral self-regulation maintains constant flow in any body position. Increased basilar artery flow during short term vertigo is probably either due to altered self-regulation or its reduction in the carotid area with compensatory basilar artery hyperflow, or else to over-response in vertebro-basilar territory.     

Is it possible to cure various disorders of stability or vertigo by surgical correction of tight stenosis of a supra-aortic artery?]

While the efficacy of vertebral arteries revascularisation on the symptoms of vertebrobasilar insufficiency (VBI = IVB in text) is well established, the effect of correction of stenosis of vessels other than the vertebral arteries on stability disorders and vertigo do not appear to have been studied to any extent. Furthermore, vertigo is not considered as specific to VBI. A retrospective study was therefore carried out to determine the outcome in 33 patients with static disorders or vertigo operated upon for a severe stenosis of a brachiocephalic trunk, a carotid artery or a subclavian artery, with or without associated stenosis of a vertebral artery which in all cases had been neglected. Two patients (6%) died during the early stages of this series. Mean duration of follow up was a little longer than 5 years. One month post-operation 61% of the survivors were asymptomatic, all the others reported marked improvement in their symptoms and all had resumed their social life. At a later stage two patients had a clinical relapse associated with new arterial stenosis. Findings in this small series suggest that it is possible to cure or improve patients with stability disorders or vertigo by the surgical correction of a severe stenosis of a supra-aortic artery other than a vertebral artery.     

糖尿病对颈内动脉狭窄介入治疗患者脑血管储备功能的影响

目的 探讨糖尿病对颈内动脉狭窄患者颈动脉支架置入术(CAS)前后脑血管储备功能的影响.方法 颈动脉狭窄≥70％的无症状性或狭窄≥50％的症状性颈动脉狭窄患者55例,分为糖尿病组(16例)和无糖尿病组(39例). 患者吸入5％CO2和95％O2混合气体诱发高碳酸血症,通过经颅多普勒超声检查,计算大脑中动脉(MCA...     

载瘤动脉狭窄对颈内-后交通动脉动脉瘤血流动力学影响的初步分析

目的 评价瘤颈近端载瘤动脉狭窄对颈内-后交通动脉动脉瘤血流动力学的影响.方法 回顾性连续纳入2018年1—6月海军军医大学附属第一医院神经外科收治的颅内动脉瘤患者438例,其中颈内-后交通动脉动脉瘤患者74例,排除了未合并载瘤动脉狭窄患者55例,发生载瘤动脉痉挛1例,三维影像资料不全8例,数据无法满足血流动力学分析要求2例,最终纳入合并瘤颈近端(狭窄距动脉瘤颈1 cm以内)载瘤动脉狭窄的颈内-后交通动脉动脉瘤住院患者8例,其中男3例,女5例;年龄49~77岁,平均(63±11)岁.根据患者DSA三维重组后载瘤动脉狭窄形态,将8例患者分为偏心性狭窄组和同心圆性狭窄组,每组4例.构建基于病例特异性的三维动脉瘤模型,采用计算机软件模拟载瘤动脉不同狭窄程度(近端载瘤动脉分别模拟30%、50%、70%、90%四种狭窄程度)和不同狭窄距离(在距离动脉瘤1 cm内的近端载瘤动脉上分别选取2.5、5.0、7.5、10.0 mm四个距离),计算动脉瘤壁面切应力(WSS)和血流速度.采用线性混合效应模型对多水平数据进行分析.结果 (1)对偏心性狭窄组进行分析显示,狭窄距离每增加2.5mm,估计动脉瘤WSS平均降低1.040 Pa,估计狭窄处血流速度平均降低33.333 m/s(均P=0.01);狭窄程度每增加20%,估计动脉瘤WSS平均增加23.988 Pa,估计狭窄处血流速度平均增加0.485 m/s,差异均有统计学意义(均P<0.01).(2)对同心圆性狭窄组进行分析显示,狭窄距离每增加2.5 mm,估计动脉瘤WSS平均降低1.109 Pa,估计狭窄处血流速度平均降低29.412 m/s,差异均有统计学意义(均P<0.01);狭窄程度每增加20%,估计动脉瘤WSS平均增加19.099 Pa,估计狭窄处血流速度平均增加0.524m/s,差异均有统计学意义(均P<0.01).结论 载瘤动脉狭窄程度的增加可导致动脉瘤WSS增大,可能与颈内-后交通动脉动脉瘤进展有关.改善狭窄程度可有效降低动脉瘤WSS,但能否延缓甚至逆转动脉瘤的进展过程尚需进一步随访、验证.     

Role of hypertension, dyslipidemia and diabetes mellitus in the development of coronary atherosclerosis in Japan

The present study evaluated the effect of hypertension (HT), dyslipidemia and diabetes mellitus (DM) on the development of coronary atherosclerosis in the Japanese population, using a cross-sectional study of 433 patients (254 men and 179 women) aged 30 years or older who underwent coronary angiography for suspected or known coronary heart disease angina at 5 cardiology departments in the Fukuoka area between September 1996 and August 1997. Patients with a disease duration of 6 months or more were excluded. The main outcome measure was angiographically defined coronary artery stenosis and was found to a significant degree in 146 patients (33.7%). HT, DM, low levels of high-density lipoprotein cholesterol (HDL-C) and hypertriglyceridemia remained as significant coronary artery disease (CAD) risk factors even after controlling for age, sex, hospital, smoking, alcohol use, body mass index and leisure time physical activity. However, hypercholesterolemia was not a significant risk factor after adjusting for these variables. After controlling for these variables, DM, low HDL-C and hypertriglyceridemia were significant CAD risk factors for men, but only DM was a significant CAD risk factor in women. These results indicate that in Japan DM, low HDL-C and hypertriglyceridemia may be more important CAD risk factors than hypercholesterolemia.     

经颅多普勒超声诊断大脑中动脉狭窄的价值

目的 探讨经颅多普勒超声(transcranial Doppler ultrasound,TCD)诊断大脑中动脉(middle cerebral artery,MCA)狭窄的价值.方法 对行数字减影血管造影(digital subtract angiography,DSA)和TCD检查的缺血性脑血管病患者的临床资料进行回顾性分析,以DSA为金标准,分析TCD诊断MCA狭窄的敏感性和特异性.对正常以及不同狭窄程度MCA的TCD血流速度进行比较,计算MCA不同狭窄程度时TCD血流速度的最佳截断值.结果 103例患者DSA证实存在MCA狭窄或闭塞,其中轻度狭窄12例,中度狭窄22例,重度狭窄40例,闭塞39例.与DSA相比,TCD检测中度以上MCA狭窄或闭塞的敏感性为78.8%,特异性为96%,准确度为93%,漏诊率为21.2%,误诊率为4%.轻度狭窄组与正常组之间血流速度无显著差异,中度狭窄组与正常组之间血流速度存在显著差异(P＜0.001),中度狭窄组与重度狭窄组之间血流速度无显著差异.判定中度狭窄的最佳收缩期峰值血流速度截断值为163.5 cm/s,平均血流速度的最佳截断值为108.5 cm/s.结论 TCD在诊断MCA狭窄或闭塞方面具有一定的优势,可作为DSA检查之前的一种安全而廉价的筛选手段.

Abstract：

Objective To explore the value of the diagnosis of middle cerebral artery (MCA) stenosis with transcranial Doppler ultrasound (TCD). Methods The clinical data in patients with ischemic cerebrovascular disease examined with digital subtract angiography (DSA)and TCD were analyzed retrospectively. DSA was used as a gold standard to analyze the sensitivity and specificity of the diagnosis of MCA stenosis with TCD. The normal and TCD blood flow velocity with different degrees of stenosis were compared. The best cut-off point of the TCD blood flow velocity of MCA at different degree of stenosis was calculated. Results DSA confirmed that 103 patients had MCA stenosis or occlusion, in which 12 were mild stenosis, 22 were moderate stenosis, 40 were severe stenosis, and 39 were occlusion. Compared to DSA, the sensitivity of TCD in detection of moderate and severe MCA stenosis or occlusion was 78. 8%, the specificity was 96. 0%, and the accuracy was 93. 0%, the missed diagnosis rate was 21. 2%, and the misdiagnosis rate was 4. 0%. As to the blood flow velocity, there was no significant difference between the mild stenosis and normal groups; while there was significant difference between the moderate stenosis and normal groups (P ＜0. 001). In addition, there was no significant difference in blood flow velocity between the moderate stenosis and severe stenosis groups. Determining the cut-off value of the best peak systolic velocity of the moderate stenosis was 163. 5 cm/s, while the best cut-off value of the mean velocity was 108. 5 cm/s. Conclusions TCD has certain advantages in the diagnosis of the MCA stenosis or occlusion, and it can be used as a safe and inexpensive screening means before DSA examination.     

应用血管超声分析椎动脉管径发育不良与眩晕的关系

目的探讨椎动脉管径发育不良与眩晕的关系。方法选择一侧椎动脉管径发育不良的患者288例,按是否存在眩晕分为眩晕组（201例）和非眩晕组（87例）。应用彩色多普勒血流显像（CDFI）和经颅多普勒超声（TCD）,分析椎动脉管径发育不良与眩晕的关系。结果①椎动脉发育不良患者眩晕发生率为69．8％（201／288）。其中椎动脉管径≤2．0mm者61例,有83．6％（51／61）的患者发生眩晕;2．0mm〈管径≤2．5mm者227例,有66．1％（150／227）的患者发生眩晕,P=0．008。②眩晕组、非眩晕组患侧椎动脉管径分别为（2．18±0．21）、（2．27±0．17）mm;健侧为（3．54±0．46）、（3．03±0．27）mm。两组比较,均P〈0．01。③眩晕组患侧椎动脉椎间隙段、颅内段收缩期峰值流速为（51±10）、（49±9）cm／s;非眩晕组为（54±11）、（52±10）cm／s,两组比较,均P〈0．05。眩晕组患侧颅内段的收缩期峰值流速明显低于椎间隙段（P〈0．05）,而非眩晕组差异无统计学意义。④椎动脉管径发育不良患者中,21～39岁、40～59岁、60～81岁眩晕发生率分别为47．6％、67．2％、80．5％,x^2=10．157,P〈0．01。结论眩晕与椎动脉管径发育不良密切相关。椎动脉管径纤细引起的血流动力学改变是造成眩晕的重要原因之一。     

Cut-off value of coronary flow velocity reserve by transthoracic Doppler echocardiography for the assessment of significant donor left anterior descending artery stenosis in patients with spontaneously visible collaterals

We evaluated the influence of collateral circulation on a donor left anterior descending artery and an appropriate cut-off value of coronary flow velocity reserve for the diagnosis of significant donor left anterior descending artery stenosis. Measurement of coronary flow velocity reserve by transthoracic Doppler echocardiography provides noninvasive assessment of significant left anterior descending artery stenosis. The cut-off value of coronary flow velocity reserve for the diagnosis of significant donor left anterior descending artery stenosis has not been well studied. We retrospectively examined 64 patients who had no significant left anterior descending artery stenosis and who had other coronary artery stenosis. Seventeen patients had collaterals from the left anterior descending artery (group A) and 47 patients did not have collaterals (group B). We prospectively examined 23 consecutive patients who had collaterals from the left anterior descending artery to other coronary arteries. Eight patients had a significant donor left anterior descending artery stenosis. Coronary flow velocity reserve assessment was performed by transthoracic Doppler echocardiography in the 2 protocols. Coronary flow velocity at baseline in group A was significantly higher than that in group B. Coronary flow velocity reserve in group A was significantly lower than that in group B (2.6 +/- 0.8 vs 3.2 +/- 0.9, p < 0.05). Coronary flow velocity during hyperemia and coronary flow velocity reserve were significantly lower in patients with significant stenosis. A cut-off value of 2.0 of coronary flow velocity reserve had a sensitivity of 88% and a specificity of 93% for the diagnosis of significant donor left anterior descending artery stenosis. In conclusion, coronary flow velocity reserve of a donor left anterior descending artery was decreased by the presence of collaterals. However, a cut-off value < 2.0 was appropriate for the diagnosis of significant donor left anterior descending artery stenosis in a population that included patients with collaterals.     

动脉粥样硬化性肾动脉狭窄临床特点分析及诊断方法比较

目的 分析动脉粥样硬化性肾动脉狭窄（ARAS）的临床特征及探讨经肾动脉超声和计算机断层扫描造影（CTA）诊断ARAS的准确性.方法 纳入2005年1月～2010年10月解放军总医院住院患者中经肾动脉造影确诊为ARAS患者179例（肾动脉狭窄＞50%）,对其临床表现进行回顾性分析,并比较肾动脉超声及肾动脉CT造影（CTA）与肾动脉造影结果的差异.结果 179例ARAS患者中,有74例（41.34%）表现为难以控制的高血压,96例（53.63%）伴胸痛,6例（3.35%）出现急性肺水肿,102例（57%）伴肾损害.其中124例ARAS患者同时进行了肾动脉超声检查,结果显示肾血流速度＞171cm/s时有最大受试者工作特征曲线（ROC）下面积,此时肾动脉超声的敏感性和特异性分别为86%和75%;另有23例（46支血管）同时进行了肾动脉CTA检查,肾动脉CTA显示的狭窄血管数多于肾动脉造影[32支（69.6%） vs.26支（56.5%）],但无统计学差异（P=0.082）.结论 ARAS临床表现多样,其中又以肾损伤、胸痛和高血压最为常见,肾动脉超声诊断ARAS的灵敏度和特异性均较高,而肾动脉CTA较肾动脉造影存在过度诊断的倾向.