Contrast-enhanced ultrasonography in evaluation of severity of renal artery stenosis
10.3760/cma.j.cn114798-20210915-00700
- VernacularTitle:超声造影在肾动脉狭窄程度分级评估中的诊断价值分析
- Author:
Yanhua CUI
1
;
Quanbin ZHANG
;
Jiping YAN
;
Ji WU
Author Information
1. 山西省人民医院超声科，太原 030012
- Keywords:
Ultrasonography;
Angiography, digital subtraction;
Renal artery obstruction
- From:
Chinese Journal of General Practitioners
2021;20(12):1288-1294
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in evaluating the severity of renal artery stenosis.Methods:Eighty six patients with suspected renal artery stenosis admitted to Shanxi Provincial People′s Hospital from January 2018 to July 2021 were enrolled in the study. All patients underwent digital subtraction angiography (DSA), Doppler ultrasonography (DUS) and CEUS examinations. With DSA results as gold standard the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS and DUS in the diagnosis of renal artery stenosis were analyzed. The consistency between CEUS and DSA in the diagnosis of renal artery stenosis was evaluated. The accuracy of DUS and CEUS in diagnosis of renal artery stenosis was assessed by the area under receiver operating characteristic (ROC) curve (AUC) and compared between groups.Results:Among 153 renal arteries from 86 patients examined by DSA, 101 showed the stenosis ≥30% (49 left and 52 right renal arteries), and there were 31, 45, 20 and 5 renal arteries with grade I, II, III and IV stenosis. The sensitivity and specificity of DUS in the diagnosis of renal artery stenosis were 74.3% (75/101) and 76.9% (40/52),respectively. DUS showed 21, 42, 20 and 4 renal arteries with grade Ⅰ, Ⅱ, Ⅲ and Ⅳ stenosis, respectively. The sensitivity and specificity of CEUS in the diagnosis of renal artery stenosis were 88.1% (89/101) and 86.5%(45/52), respectively. CEUS showed 26, 43, 23 and 4 renal arteries with grade Ⅰ, Ⅱ, Ⅲ and Ⅳ stenosis, respectively. There was a significant difference between DUS and DSA in grading of renal artery stenosis (χ2=4.447, P=0.03),and there was a moderate consistency between DUS and DSA ( Kappa=0.480). There was no significant difference between CEUS and DSA in grading renal artery stenosis (χ2=0.842, P=0.36) with a good consistency ( Kappa=0.730). The AUC of CEUS in diagnosis of renal artery stenosis was higher than that of DUS [0.873 (95% CI: 0.808-0.938) vs. 0.756 (95% CI:0.673-0.839); Z=4.361, P<0.01]. Conclusion:The study suggests that contrast-enhanced ultrasonography may be used as a diagnostic method for grading renal artery stenosis.
