Accuracy of colour duplex sonography for the diagnosis of renal artery stenosis.
Artikel i vetenskaplig tidskrift, 2009

OBJECTIVE: To examine the diagnostic value of novel velocimetric colour duplex sonography indices in the screening of renal artery stenosis (RAS). METHODS: We performed a retrospective analysis of all consecutively studied patients at our centre with suspected RAS, and a colour duplex sonography carried out at less than 4 months (mean 34 days) before renal angiography during a 6-year period (2002-2007). A significant RAS was defined as an at least 60% stenosis on angiography or a transstenotic mean arterial pressure gradient of at least 10 mmHg or both. RESULTS: In a total of 169 patients, 111 stenotic and 206 nonstenotic kidneys were examined. The sensitivity and specificity for acceleration of blood flow in early systole (ACCmax) were 85 and 75%, respectively, and for the acceleration index (ACCmax/peak systolic velocity, AImax) 83 and 79%, respectively. Corresponding values in patients with estimated glomerular filtration rate of less than 30 ml/min/1.73 m2 were 90 and 73% (for ACCmax) and 74 and 88% (for AImax). In addition, the transstenotic mean arterial pressure gradient showed a significant, though weak, negative correlation to ACCmax (r = -0.26, P = 0.02) and AImax (r = -0.29, P = 0.01) in stenotic kidneys. CONCLUSION: ACCmax and AImax provide similar, good diagnostic accuracy in the detection of a haemodynamically significant RAS, even in patients with markedly reduced glomerular filtration rate. Presumably, the lack of superiority of the novel index AImax could be explained by a highly homogenous methodological approach in the present single-centre study.

Humans

Female

Male

physiopathology

Doppler

ultrasonography

Glomerular Filtration Rate

Ultrasonography

Aged

Renal Artery Obstruction

Duplex

Systole

Retrospective Studies

methods

Adult

Middle Aged

Författare

Aso Saeed

Göteborgs universitet

Göran Bergström

Göteborgs universitet

Karin Zachrisson

Göteborgs universitet

Gregor Guron

Göteborgs universitet

Elzbieta Nowakowska-Fortuna

Göteborgs universitet

Ellen Fredriksen

Göteborgs universitet

Gert Jensen

Göteborgs universitet

Hans Herlitz

Göteborgs universitet

Journal of hypertension

1473-5598 (ISSN)

Vol. 27 1690-6

Ämneskategorier

MEDICIN OCH HÄLSOVETENSKAP

DOI

10.1097/HJH.0b013e32832c417d

PubMed

19542896