彩色多普勒超声与DSA诊断肾动脉狭窄的对比研究-东南大学学报医学版

彩色多普勒超声与DSA诊断肾动脉狭窄的对比研究

单位：东南大学附属中大医院超声诊断科, 江苏南京 210009

分类号：R543.5;R445.1

出版年·卷·期（页码）：2013·32·第四期（413-416）

摘要：

目的: 探讨彩色多普勒超声诊断肾动脉狭窄(RAS)的临床价值。方法: 对临床拟诊RAS的18例患者的36支肾动脉进行彩色多普勒超声检查,根据肾动脉形态学和血流动力学超声表现评价肾动脉有无狭窄;同期进行肾动脉数字减影血管造影(DSA),并对两者检查结果进行对比分析。结果: 在超声检查发现RAS的11支肾动脉中,有10支与DSA符合,假阳性1支;在超声检查未发现RAS的25支肾动脉中,DSA发现3支肾动脉存在RAS,假阴性3支,超声符合率为88.9%(32/36)。超声检查结果与DSA比较:经Kappa检验,测值为0.75(P >0.05);经McNemar检验,测值为0.625(P >0.05),表明本组病例彩色多普勒超声和DSA检查对RAS诊断的一致性较好,两种方法对RAS的诊断率没有明显差异。结论: 肾动脉彩色多普勒超声是诊断RAS的一种简便、有效、可重复性好的检查方法,具有很高的临床应用价值。

Objective: To investigate the clinical value of color Doppler ultrasound in diagnosis of renal artery stenosis(RAS). Methods: In 18 cases of RAS suspected clinically, 36 renal arteries were examined by color Doppler ultrasound according to renal artery morphology and hemodynamics. Ultrasound assessment of renal artery was done to find out if there was presence of stenosis or not; at the same time renal artery digital subtraction angiography (DSA) was done.Both the results of color Doppler ultrasound and DSA were paired to each other and compared separately and were finally analyzed statistically. Results: Among 11 RAS diagnosed by Ultrasound, 10 were confirmed by DSA (1 false positive); Among 25 normal renal artery diagnosed by Ultrasound, 3 RAS were revealed by DSA (3 false negative). Ultrasound accordance rate is 88.9%(32/36). Test results of ultrasound exam and DSA imaging in the diagnosis of RAS were compared statistically. Kappa measured value was 0.75(P>0.05), showed that this group of patient examined by DSA and ultrasound had good consistency in diagnosis of RAS; McNemar test measured value was 0.625(P>0.05), showed that in the group of patients the rate of diagnosis in RAS by ultrasonography and DSA had no obvious difference. Conclusion: Color Doppler ultrasound in diagnosis of RAS is a simple, effective, can be done repeatedly and has high clinical value way.

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