Assessment of renal artery stenosis: comparison of captopril renography and gadolinium-enhanced breath-hold MR angiography.
Assessment of renal artery stenosis: comparison of captopril renography and gadolinium-enhanced breath-hold MR angiography.
复制标题
肾动脉狭窄的评估：卡托普利肾造影和钆增强屏气磁共振血管造影的比较。
作者：
V. Bongers;J. Bakker;J. Beutler;F. Beek;J. D. Klerk
目标
目的探讨卡托普利肾成像(CR)和屏气磁共振(MR)血管成像对50~99%肾动脉狭窄(RAS)的诊断价值。
材料和方法
43例可能存在RAS的患者，其中53%有肾功能损害(肌酐130微克/L)，口服卡托普利25 mg后行~(99m)Tc-巯基乙酰甘氨酸(MAG(3))肾造影术。磁共振血管成像采用1.5Tesla标准系统：TR13.5，TE 3.5，翻转角60度，矩阵195×512。以动脉内数字减影血管造影(DSA)为参照标准。
结果
卡托普利肾造影术准确地对26例患者中的22例进行了分类，这些患者的单侧或双侧RAS为50-99%。CR诊断50~99%狭窄的敏感性为85%，特异性为71%。在磁共振血管成像中，一条闭塞的动脉被误诊为狭窄。灵敏度为100%，特异度为94%。MR血管成像与CR的准确性差异有统计学意义(P=0.02)。肾功能损害患者CR的准确率(70%)低于肾功能正常者(90%)。
结论
MR血管成像对RAS的诊断准确率在50%~99%之间。CR的准确性不如MR血管成像，尤其是在肾功能受损的患者。然而，在肾功能正常的患者中，CR仍然是一项有用的诊断试验。
AIM
To determine the accuracy of captopril renography (CR) and gadolinium-enhanced breath-hold magnetic resonance (MR) angiography in the diagnosis of 50-99% renal artery stenosis (RAS).
MATERIALS AND METHODS
Forty-three patients with possible RAS, of whom 53% had renal function impairment (creatinine >130 micromol/l), were included.(99m)Tc-mercaptoacetyl triglycine (MAG(3)) renography was performed after an oral dose of 25 mg captopril. Gadolinium-enhanced MR angiography was performed on a standard 1.5 Tesla system: TR 13.5, TE 3.5, flip angle 60 degrees, matrix 195 x 512. Intra-arterial digital subtraction angiography (DSA) was the standard of reference.
RESULTS
Captropril renography accurately categorized 22 of 26 patients who had either uni- or bilateral RAS of 50-99%. The sensitivity and specificity of CR for the detection of 50-99% stenosis were 85 and 71%, respectively. With MR angiography one occluded artery was incorrectly diagnosed as a stenosis. Sensitivity and specificity were 100 and 94%, respectively. The difference between the accuracies of MR angiography and CR was statistically significant (P = 0.02). The accuracy of CR was lower in patients with renal impairment (70%) than in those with normal renal function (90%).
CONCLUSION
MR angiography showed a high accuracy in diagnosing RAS of between 50 and 99%. CR was less accurate than MR angiography, especially in patients with renal function impairment. In patients with normal renal function, however, CR remains a useful diagnostic test.
同时进行正碘马尿酸盐和二乙烯三胺五乙酸卡托普利肾造影的前瞻性研究。
DOI：
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发表时间：
1998
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
Blaufox,MD;Fine,EJ;Heller,S;Hurley,J;Jagust,M;Li,Y;Mann,SJ;Pickering,TG;Zanzonico,P;Zhang,CG
通讯作者：
Zhang,CG