彩色多普勒超声在肾动脉狭窄诊断中的应用

【】　目的　评价彩色多普勒超声对肾动脉狭窄（ARAS）的诊断指标及准确性。　方法　1999年10月-2008年12月对患有高血压病的58例共113根肾动脉进行彩色多普勒超声检查。每例患者均测量肾动脉峰值流速（PSV）与肾内段动脉的阻力指数及肾脏长轴。在双盲条件下，以患者肾动脉造影、MRI血管造影及CT血管造影为标准，评价彩色多普勒超声诊断ARAS的诊断指标及准确性。　结果　彩色多普勒超声诊断肾动脉狭窄的敏感性为60%，特异性为83%，阳性预测值为83%，阴性预测值为61%。患侧肾长轴小于健侧肾长轴，患侧肾峰值流速高于健侧肾峰值流速，患侧肾阻力指数低于健侧肾阻力指数。　结论　肾动脉彩色多普勒超声对于肾动脉狭窄初筛诊断以及评价肾动脉狭窄介入治疗后的近、远期疗效，是一种简便可靠的无创检查手段。？【Abstract】　Objective　ToevaluatetheaccuracyandindexofcolorDopplerultrasonography(CDU)diagnosingrenalarterystenosis(RAS).〖WTHZ〗Methods〖WTBZ〗Atotalof113renalarteriesof58patientswithhypertensionfromOctober1999toDecember2008wereexaminedbyCDU.Thepeaksystolicvelocity(PSV)oftherenalartery,resistantindexofinteriorarteryofkidney,andlongaxisofkidneyofeachpatientwereobtained.Underthedouble-blindcondition,accuracyanddiagnosticindexofCDUfordiagnosingRASwereevaluatedaccordingtothestandardofrenalarteriography,magneticresonanceangiographyorcomputerizedtomographyangiography.　Results　ThesensitivityofCDUfordiagnosingRASwas60%,specificitywas83%,positivepredictivevaluewas83%,andnegativepredictivevaluewas61%.LongaxisofkidneyinpatientswithRASwasshorterthanthatinthehealthyones.ThePSVinpatientswithRASwashigherthanthatinthehealthyones,andtheresistantindexofsectionarteryofkidneyinpatientswithRASwaslowerthanthatinthehealthyones.　Conclusion　CDUisaneasyandreliablenon-invasiveexaminationforearlydiagnosisandscreeningofRASandforevaluatingashort-orlong-termtherapeuticeffect.