摘要
目的 探讨肾内动脉的Tardus-Parvus波形对不同病因肾动脉狭窄（RAS）的诊断价值.方法 经彩色多普勒血流显像检查并进行肾动脉造影的RAS患者81例,其中大动脉炎组29例,纤维肌肉发育不良组22例,动脉粥样硬化组30例.测量叶间动脉加速时间（AT）、阻力指数（RI）,并计算双侧RI差值（ΔRI）.结果 肾动脉造影共显示肾动脉中度狭窄（50%～69%）16条,重度狭窄（70%～99%）80条和完全闭塞15条.对于重度狭窄,AT≥0.07 s的敏感性为93%,特异性为100%.在内径减少≥70% 的非动脉粥样硬化性RAS中,RI＜0.50 的敏感性78%,特异性95%.在内径减少≥70% 的单侧狭窄患者中,ΔRI＞0.05 的敏感性86%,特异性60%,准确性81%;ΔRI＞0.08 的敏感性69%,特异性80%,准确性71%.结论 对于内径减少≥70% RAS,AT≥0.07 s的诊断价值最好,且适合3类常见RAS;RI＜0.50 对大动脉炎性和纤维肌肉发育不良性RAS的诊断价值较高,而对动脉粥样硬化性RAS的诊断价值不大;ΔRI的诊断阈值以 0.05 较为合适,适合单侧RAS.
Objective To evaluate the diagnostic value of Tardus-Parvus pattern in the detection of different types of renal artery stenosis（RAS）. Methods A study group was composed of 81 patients whose renal arteries were detected by color Doppler flow imaging and were referred to renal arteriography afterwards, including 29 Takayasu arteritis, 22 fibromascular dysplasia and 30 atherosclerosis. Doppler spectra of interlobar arteries were obtained, and the acceleration time（AT）, the resistive index（RI） and the side-to-side differences of RI（ARI） were measured or calculated. Results Renal angiography revealed 16 moderate RAS （diameter reduction 50% ～69%）, 80 severe RAS diameter reduction 70% ～99%）, and 15 total occlusions. The sensitivity and specificity of AT≥0.07 s for predicting all severe RAS were 93 % and 100%, and those of Ri〈0.50 for predicting non-atherosclerosis severe RAS were 78% and 95%, respectively. In the patients with ≥70% unilateral RAS, the sensitivity, specificity, and overall accuracy for △RI〉0.05 were 86%, 60% and 81%, and for △RI〉0.08 were 69%,80% and 71%,respectively. Conclusions AT≥0.07 s is the best parameter for predicting ≥70% RAS, and suitable for the three common RASs. RI〈0. 50 for predicting a severe RAS is better in non-atherosclerosis patients. The cutoff of ARI had better to set at 0.05 for unilateral severe stenosis.
出处
《中华超声影像学杂志》
CSCD
2006年第9期677-680,共4页
Chinese Journal of Ultrasonography
关键词
超声检查
多普勒
肾动脉梗阻
血液动力学现象
Ultrasonography, Doppler
Renal artery obstruction
Hemodynamic phenomena
