Superb micro-vascular imaging in the diagnosis of renal artery stenosis
Objective To explore the value of color Doppler ultrasound(CDU)in combination with superb micro-vascular imaging(SMI)to the diagnosis of renal artery stenosis.Methods From October 2020 to December 2022,113 patients were diagnosed with secondary hypertension in the First Affiliated Hospital of Jiamusi University.CDU was performed to measure the residual inner diameter of the renal aortic stenosis site and normal lumen inner diameter,the renal aortic stenosis rate was calculated,and the degree of renal artery stenosis was evaluated.For patients with severe renal artery stenosis or occlusion demonstrated by CDU,SMI was used to calibrate the residual inner diameter of the stenosis site,to observe whether there was low-speed blood flow in the occlusion site and renal interlobar artery,and to re-evaluate the degree of renal artery stenosis.All 113 patients underwent CT angiography(CTA).According to the CT A results as the golden standard,Kappa test was used to evaluate the consistency of CDU alone,and CDU in combination with SMI in diagnosing moderate to severe renal artery stenosis and occlusion.Results(1)CTA diagnosed 34 renal arteries of moderate stenosis,28 of severe stenosis and 6 of occlusion.(2)CDU diagnosed 28 renal arteries of moderate stenosis,27 of severe stenosis,and 13 of occlusion.After calibration by SMI,4 renal arteries of occlusion were diagnosed as severe stenosis,and 4 arteries of severe stenosis were diagnosed as moderate stenosis.(3)Compared with the CTA results for diagnosing moderate to severe stenosis and occlusion,the consistency rate of CDU was 67.65％,with a Kappa value of 0.473(x2=35.109,P＜0.001),and the consistency rate of CDU combined with SMI was 85.29％,with a Kappa value of 0.751(x2=66.469,P＜0.001).Conclusion CDU in combination with SMI can improve the diagnostic accuracy rate of moderate to severe renal artery stenosis and occlusion,and can be used as an effective screening method.
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