AI Summary & Key Takeaways
AI InsightDoppler US offers many advantages as it is a rapid, non-invasive screening method in the diagnosis of renal artery stenosis, also it is does not need any contrast agents. 3D-MRA allows more accurate evaluation of patients with stenosis on doppler US without the known risks associated with nephrotoxic contrast agents, ionizing radiation or arterial catheterization and it may be usefull tool to preventing false positive tests.
📌 3 Key Takeaways
Abstract
The aim of our retrospective study was to compare the value of doppler sonography (US) and three-dimensional gadolinium-enhanced MR angiography (3D-MRA) for detecting renal artery stenosis. Sixty-four patients (36 men, 28 women), suspected of having renal artery stenosis with clinical and laboratory findings were enrolled in this study. 102 renal arteries were evaluated with doppler US, contrast-enhanced 3DMRA and selective renal artery digital subtraction angiography (DSA) respectively. Doppler US and MR angiographic findings were compared with DSA which is the gold standard technique for the diagnosis of renal artery stenosis. Stenosis in renal artery was detected in 82 renal arteries by Doppler US. Visible narrowing of renal artery was present in 70 arteries on source and MIP images by MRI. Stenosis was found in 65 arteries by DSA. According to these findings doppler US had a sensitivity of 97% and specificity of 49% compared to DSA. Magnetic resonance angiography was the more accurate screening test with sensitivity of 97%, specifity of 81% compared doppler US. Doppler US offers many advantages as it is a rapid, non-invasive screening method in the diagnosis of renal artery stenosis, also it is does not need any contrast agents. 3D-MRA allows more accurate evaluation of patients with stenosis on doppler US without the known risks associated with nephrotoxic contrast agents, ionizing radiation or arterial catheterization and it may be usefull tool to preventing false positive tests.
Özet
Bu retrospektif çalışmada renovasküler hipertansiyonlu olgularda, renal arter stenozunu saptamaya yönelik doppler ultrasonografi (US) ve üç boyutlu kontrastlı manyetik rezonans anjiyografinin (3B-MRA) tanısal etkinliğini saptamayı amaçladık. Renal arter stenozu şüphesi olan, yaşları 31-77 arasında değişen, 36'sı erkek, 28'i kadın toplam 64 olgu çalışmaya dahil edildi. Tüm olgularda doppler US ve 3B-MRA ile renal arterlerde darlık araştırıldı. Doppler US ya da 3B-MRA ile değerlendirilen tüm hastalara altın standart olarak kabul edilen Dijital Subtraction Anjiografi (DSA) tetkiki uygulandı. Sonuçlar karşılaştırmalı olarak değerlendirildi. Yetersiz tetkik nedeniyle 12 hasta (23 renal arter) çalışma dışı bırakıldı. Çalışmaya dahil edilen 102 renal arterin doppler US'de 82'sinde, 3B-MRA'da ise 70'inde stenoz saptandı. DSA'da da 65 renal arterde darlık izlendi. Tüm bu bulgulara göre Doppler US'nin duyarlılığı % 97, özgüllüğü %49 bulundu. 3B-MRA'nun duyarlılık ve özgüllük değerleri sırasıyla %97 ve %81 idi. Doppler US renal arter stenozu şüphesi olan olgularda; kontrast madde gerektirmeyen ve radyasyon içermeyen, non-invaziv bir tarama yöntemidir. Doppler US'de stenoz saptanan olgularda kontrastlı 3B-MRA ile değerlendirme, yalancı pozitif sonuçları engelleyebilir.