Diagnostic efficacy of contrast-enhanced ultrasound for renal artery stenosis in elderly patients and imaging features
10.3760/cma.j.issn.0254-9026.2023.12.011
- VernacularTitle:老年肾动脉狭窄超声造影诊断效能及超声造影表现特点
- Author:
Yang WANG
1
;
Yan LI
;
Yuewei ZHANG
;
Na MA
;
Junhong REN
Author Information
1. 北京医院超声科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Contrast-enhanced ultrasound;
Renal artery stenosis;
Diagnosis;
Renal insufficiency
- From:
Chinese Journal of Geriatrics
2023;42(12):1453-1457
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic efficacy of contrast-enhanced ultrasound(CEUS)for renal artery stenosis in elderly patients and the imaging features.Methods:Clinical and imaging data of 1 074 patients aged 60 years or older receiving renal artery CEUS in our hospital between September 2017 and October 2022 were retrospectively and consecutively collected, and the results of renal artery CEUS were summarized and comparatively analyzed.Results:Among the 1 074 elderly patients, 588(54.7%)patients showed normal renal artery imaging on CEUS, while 486(45.3%)patients exhibited renal artery stenosis.Of the 486 patients diagnosed with renal artery stenosis by CEUS, 94 elderly patients with complete clinical data then underwent DSA.Comparison of CEUS and DSA results from the 94 patients revealed that CEUS was in good agreement with DSA in evaluating different degrees of renal artery stenosis( Kappa value: 0.739, P<0.001). Of the 486 patients with renal artery stenosis diagnosed by CEUS, a total of 684 renal arteries had varying degrees of stenosis(including 288 with unilateral stenosis and 198 with bilateral stenosis), of which 55(8.0%)had diffuse stenosis of the main renal artery, and 629(92.0%)had confined stenosis of renal arteries(609 stenosis sites were located in the proximal segment/entry point, 12 in the middle segment, and 8 in the hilar or segmental renal arteries). Ultrasonography of confined renal artery stenosis showed narrowing of the contrast agent sound beam at the stenosis site, with or without enhancement of contrast intensity; ultrasonography of diffuse renal artery stenosis showed a thin contrast sound beam throughout the length of the renal artery, with either continuous linear changes or intermittently punctuated changes. Conclusions:There is a high detection rate of renal artery stenosis in the elderly, and ultrasonography can not only determine the degree of renal artery stenosis, but also show the location of stenosis and the extent of involvement, with fairly clear imaging characteristics.
