彩色多普勒超声在肾动脉狭窄诊断中的应用

目的评价彩色多普勒超声对肾动脉狭窄（ARAS）的诊断指标及准确性。方法 1999年10月2008年12月对患有高血压病的58例共113根肾动脉进行彩色多普勒超声检查。每例患者均测量肾动脉峰值流速（PSV）与肾内段动脉的阻力指数及肾脏长轴。在双盲条件下,以患者肾动脉造影、MRI血管造影及CT血管造影为标准,评价彩色多普勒超声诊断ARAS的诊断指标及准确性。结果彩色多普勒超声诊断肾动脉狭窄的敏感性为60%,特异性为83%,阳性预测值为83%,阴性预测值为61%。患侧肾长轴小于健侧肾长轴,患侧肾峰值流速高于健侧肾峰值流速,患侧肾阻力指数低于健侧肾阻力指数。结论肾动脉彩色多普勒超声对于肾动脉狭窄初筛诊断以及评价肾动脉狭窄介入治疗后的近、远期疗效,是一种简便可靠的无创检查手段。

Application of Color Doppler Ultrasonography in Diagnosing Renal Artery Stenosis

Objective To evaluate the accuracy and index of color Doppler ultrasonography （CDU） diagnosing renal artery stenosis （RAS）.Methods A total of 113 renal arteries of 58 patients with hypertension from October 1999 to December 2008 were examined by CDU. The peak systolic velocity （PSV） of the renal artery, resistant index of interior artery of kidney,and long axis of kidney of each patient were obtained. Under the double-blind condition, accuracy and diagnostic index of CDU for diagnosing RAS were evaluated according to the standard of renal arteriography, magnetic resonance angiography or computerized tomography angiography. Results The sensitivity of CDU for diagnosing RAS was 60%, specificity was 83%, positive predictive value was 83%, and negative predictive value was 61%. Long axis of kidney in patients with RAS was shorter than that in the healthy ones. The PSV in patients with RAS was higher than that in the healthy ones, and the resistant index of section artery of kidney in patients with RAS was lower than that in the healthy ones. Conclusion CDU is an easy and reliable non-invasive examination for early diagnosis and screening of RAS and for evaluating a short-or long-term therapeutic effect.