• 四川大學(xué)華西醫(yī)院超聲科（成都，610041）;

【摘要】　目的　 評(píng)價(jià)彩色多普勒超聲對(duì)腎動(dòng)脈狹窄（ARAS）的診斷指標(biāo)及準(zhǔn)確性。　方法　 1999年10月-2008年12月對(duì)患有高血壓病的58例共113根腎動(dòng)脈進(jìn)行彩色多普勒超聲檢查。每例患者均測(cè)量腎動(dòng)脈峰值流速（PSV）與腎內(nèi)段動(dòng)脈的阻力指數(shù)及腎臟長(zhǎng)軸。在雙盲條件下，以患者腎動(dòng)脈造影、MRI血管造影及CT血管造影為標(biāo)準(zhǔn)，評(píng)價(jià)彩色多普勒超聲診斷ARAS的診斷指標(biāo)及準(zhǔn)確性。　結(jié)果　 彩色多普勒超聲診斷腎動(dòng)脈狹窄的敏感性為60%，特異性為83%，陽性預(yù)測(cè)值為83%，陰性預(yù)測(cè)值為61%?；紓?cè)腎長(zhǎng)軸小于健側(cè)腎長(zhǎng)軸，患側(cè)腎峰值流速高于健側(cè)腎峰值流速，患側(cè)腎阻力指數(shù)低于健側(cè)腎阻力指數(shù)。　結(jié)論　 腎動(dòng)脈彩色多普勒超聲對(duì)于腎動(dòng)脈狹窄初篩診斷以及評(píng)價(jià)腎動(dòng)脈狹窄介入治療后的近、遠(yuǎn)期療效，是一種簡(jiǎn)便可靠的無創(chuàng)檢查手段。
【Abstract】　Objective　 To evaluate the accuracy and index of color Doppler ultrasonography (CDU) diagnosing renal artery stenosis (RAS).〖WTHZ〗Methods〖WTBZ〗A total of 113 renal arteries of 58 patients with hypertension from October 1999 to December 2008 were examined by CDU. The peak systolic velocity (PSV) of the renal artery, resistant index of interior artery of kidney,and long axis of kidney of each patient were obtained. Under the double-blind condition, accuracy and diagnostic index of CDU for diagnosing RAS were evaluated according to the standard of renal arteriography, magnetic resonance angiography or computerized tomography angiography.　Results　 The sensitivity of CDU for diagnosing RAS was 60%, specificity was 83%, positive predictive value was 83%, and negative predictive value was 61%. Long axis of kidney in patients with RAS was shorter than that in the healthy ones. The PSV in patients with RAS was higher than that in the healthy ones, and the resistant index of section artery of kidney in patients with RAS was lower than that in the healthy ones.　Conclusion　 CDU is an easy and reliable non-invasive examination for early diagnosis and screening of RAS and for evaluating a short-or long-term therapeutic effect.

引用本文： 陳楊,文曉蓉,羅燕,林玲,時(shí)瑩瑜. 彩色多普勒超聲在腎動(dòng)脈狹窄診斷中的應(yīng)用. 華西醫(yī)學(xué), 2010, 25(12): 2210-2213. doi: 復(fù)制

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  1. 1. 　Safian RD, Textor SC. Renal-artery stenosis[J]. N Engl J Med, 2001, 344: 431-442.
  2. 2. 　Conlon PJ, 0 Riordan E, Kalra PA. New insights into the epidemiologic and clinical manifestations of atherosclerotic renovascular disease[J]. Am J Kidney Dis, 2000, 35: 573-587.
  3. 3. 　楊進(jìn)剛, 胡大一, 劉坤申, 等. 冠狀動(dòng)脈造影患者中腎動(dòng)脈狹窄的發(fā)生率[J]. 中華內(nèi)科雜志, 2002, 1: 24-27.
  4. 4. 　張奇, 沈衛(wèi)峰, 張瑞巖, 等. 連續(xù)847例冠狀動(dòng)脈造影術(shù)后即刻行選擇性腎動(dòng)脈造影臨床總結(jié)[J]. 中國動(dòng)脈硬化雜志, 2003, 11: 254-256.
  5. 5. 　Rundback JH, Sacks D, Kent KC, et al. Guidelines for the reporting of renal artery revascularization in clinical trials[J]. J Vasc Interv Radio1, 2002, 13: 959-974.
  6. 6. 　Hoffmann U, Edwards JM, Carter S, et al. Role of duplex scanning for the detection of atherosclerotic renal artery disease[J]. Kidney Int, 1991, 39: 1232-1239.
  7. 7. 　Olin JW. Role of the duplex ultrasonography in screening for significant renal artery disease[J]. Urol Clin North Am, 1994, 12: 215-226.
  8. 8. 　Olin JW, Piedmone MR, Young JR, et al. The utility of duplex ultrasound scanning of the renal arteries for diagnosing RAS[J]. Ann Intern Med, I995, 122: 833-838.
  9. 9. 　李建初, 張縉熙, 周墨寬, 等. 彩色多普勒超聲對(duì)腎動(dòng)脈狹窄的評(píng)價(jià)[J]. 中華超聲影像學(xué)雜志, 1996, 5: 159-161.
  10. 10. 　Benny Drieghe, Juraj Madaric. Assessment of renal artery stenosis: side-by-side comparison of angiography and duplex ultrasound with pressure gradient measurements[J]. European Heart Journal, 2008, 29: 517-524.
  11. 11. 　Krumme B, Blum U, Schwertfeger E, et al. Diagnosis of renovascular disease by intra-and extrarenal Doppler scanning[J]. Kidney Int, 1996, 50: 1288-1292.
  12. 12. 　Souza de Oliveira IR, Widman A, Molnar LJ, et al. Colour Doppler ultrasound: a new index improves the diagnosis of renal artery stenosis[J]. Ultrasound Med Biol, 2000, 26: 41-47.
  13. 13. 　Leiner MT, W de Haan PJ. Nelemans Contemporary imaging techniques for the diagnosis of renal artery stenosis[J]. Eur Radiol, 2005, 15: 2219-2229.
  14. 14. 　蘭永樹, 唐光才, 李春志, 等. 正常活體腎臟多層螺旋CT成像研究[J]. 實(shí)用放射學(xué)雜志, 2007, 9: 1245-1249.
  15. 15. 　蔣雄京, 戴玉華, 朱文玲, 等. 彩色多普勒血流頻譜診斷腎動(dòng)脈狹窄的研究[J]. 中國超聲醫(yī)學(xué)雜志, 1994, 10(6): 28-31.
  16. 16. 　許玉峰, 唐光健. CT測(cè)量腎臟皮質(zhì)厚度與年齡關(guān)系的研究[J]. 中華放射學(xué)雜志, 2004, 38(8): 805-810.