彩色多普勒超声与磁共振血管造影诊断老年动脉粥样硬化性肾动脉狭窄的对比研究

目的评价彩色多普勒超声与对比增强磁共振血管造影(CE-MRA)诊断老年动脉粥样硬化性肾动脉狭窄(ARAS)的价值。方法选择经彩色多普勒血流成像(CDFI)筛查和CE-MRA检查明确诊断为ARAS的患者40例,21例行数字减影血管造影(DSA)检查,比较其影像学结果。结果与CE-MRA比较,CDFI诊断ARAS病变血管的符合率为90.6%,诊断狭窄部位准确率为100%,ARAS患者的CDFI血流形态和狭窄类型与CE-MRA高度一致;不同狭窄程度组之间血流参数比较,差异有统计学意义(P<0.05)。ARAS患者40例(58支)经CE-MRA与经CDFI诊断的K系数为0.861(P<0.001),21例(32支)经DSA与经CE-MRA诊断的K系数为0.850(P<0.001),诊断一致性好。结论 CDFI作为一种无创性检查,其对ARAS的诊断效能与CE-MRA接近,具有很高的临床应用价值,可作为老年ARAS患者首选的检查方法。

Comparative study of color Doppler flow imaging and CE-MRA in diagnosis of atherosclerotic renal artery stenosis in elder

To evaluate the clinical value of color Doppler flow imaging （CDFI） and contrastenhanced magnetic resonance angiography （CEMRA） in diagnosis of atherosclerotic renal artery stenosis （ARAS） in elder. Methods Forty patients with ARAS examined by both CDFI and CEMRA were enrolled in this study, 21of them were examined by DSA, Then the results were compared. Results Compared with CE-MRA, the coincidence rate of CDFI in diagnosis of stenosis arteries of ARAS was 90.6% , and the accuracy of CDFI in detecting stenosis location of ARAS was 100%. The results in CDFI were consistent with those of CEMRA. The Doppler velocity parameters had significant difference among the groups of different degree of stenosis（P〈0.05）. There were 40 participants who had conducted both CEMRA and CDFI in evaluation of ARAS with the kappa coefficient of O. 861 （ P〈0. 001 ）, and 20 participants who had undergone both DSA and CE-MRA, with the kappa coefficients of 0. 850 （P〈0. 001 ）. Conclusion Compared with CEMRA, CDFI has the same value in evaluating ARAS,it can be used as a preferred noninvasive method for ARAS in elder.