流入敏感翻转恢复序列MR血管造影诊断肾动脉狭窄

目的前瞻性评价非对比增强流入敏感翻转恢复(IFIR)序列MRA(IFIR-MRA)对肾动脉狭窄的诊断价值。方法对60例可疑肾血管性高血压患者行肾动脉IFIR-MRA和增强CTA检查,比较两种方法的图像质量、肾动脉显影效果和肾动脉狭窄分级。以Spearman相关系数评价两种方法所得结果的相关性。以CTA为参照,计算IFIR-MRA诊断肾动脉狭窄的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和准确率。结果 CTA和IFIR-MRA均显示126支主肾动脉。IFIR-MRA图像质量、肾动脉分级及肾动脉狭窄诊断与CTA结果的Spearman相关系数分别为0.773、0.998和0.833(P均<0.001)。IFIR-MRA诊断肾动脉狭窄的敏感度、特异度、PPV、NPV和准确率分别为100%(23/23)、98.06%(101/103)、92.00%(23/25)、100%(101/101)和98.41%(124/126)。结论以CTA为参照,非对比增强IF-IR-MRA可良好显示肾动脉,诊断肾动脉狭窄具有很高的敏感度、特异度和准确率,可作为可疑肾动脉狭窄患者的首选检查方法。

MR angiography with non-enhanced inflow-sensitive inversion recovery pulse sequence in diagnosis of renal artery stenosis

Objective To observe the diagnostic value of non-enhanced inflow-sensitive inversion recovery (IFIR) MRA (IFIR-MRA) in detection of renal artery stenosis (RAS). Methods Sixty patients with suspicious renovascular hypertension underwent both IFIR-MRA and enhanced CTA. The imaging quality, renal artery display and renal artery grading were all evaluated. Spearman correlation analysis was used to assess the correlation between the two methods. Compared with CTA, the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rate for IFIR-MRA on detection RAS were calculated. Results Totally 126 main renal arteries in 60 patients were checked on CTA and IFIR-MRA, respectively. The Spearman correlation coefficient was 0.773 (P<0.001) for renal artery display, 0.998 (P<0.001) for renal arteries grading and 0.833 (P<0.001) for RAS detection. The sensitivity, specificity, PPV, NPV and accuracy of IFIR-MRA for detection RAS was 100% (23/23), 98.06% (101/103), 92.00% (23/25), 100% (101/101) and 98.41% (124/126), respectively. Conclusion Non-enhanced IFIR-MRA could gain quite good renal artery imaging quality and high sensitivity, specificity, accuracy rate for detecting RAS. It could be regarded as the first choice for imaging examination of patients with suspicious RAS.