Colour Doppler ultrasound: a new index improves the diagnosis of renal artery stenosis

Oliveira, Ilka Regina Souza de; Widman, Azzo; Molnar, Laszlo J.; Fukushima, Júlia Tizue; Praxedes, José Nery; Cerri, Giovanni Guido

doi:10.1016/s0301-5629(99)00119-2

Cited by 34 publications

(45 citation statements)

References 31 publications

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“…A similar Doppler parameter called the renalsegmental ratio (RSR) (the proximal renal artery PSV divided by the segmental artery PSV) has been used to evaluate native renal arterial stenosis, and for the detection of a 50% stenosis the RSR >5 has been regarded as the best Doppler criterion compared with conventional Doppler parameters. 22 In our study, the cutoff value of the Post-PSV for the diagnosis of TRAS was larger than that of the RSR for the diagnosis of a native renal arterial stenosis. The following are possible explanations.…”

Section: Discussioncontrasting

confidence: 59%

Evaluation of severe transplant renal artery stenosis with Doppler sonography

Cai

et al. 2005

J. Clin. Ultrasound

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Section: Discussioncontrasting

confidence: 59%

Evaluation of severe transplant renal artery stenosis with Doppler sonography

Cai

et al. 2005

J. Clin. Ultrasound

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“…a ratio of PSV measured in the renal artery to that obtained in the segmental artery, was the best parameter (sensitivity 93.33%; specificity 89.47%). Other authors [26] found that renal-interlobar ratio (RIR), i.e. a ratio of PSV measured in the renal artery to that obtained in the interlobar artery, was more accurate (sensitivity 88%; specificity 88%).…”

Section: Proximal Criteria (Direct Evaluation Of the Stenosis)mentioning

confidence: 99%

“…Interobserver and intraobserver variability using these criteria is high [29,30]. The rationale is that the flow at the renal hilum downstream to a hemodynamically significant stenosis should become damped and show a slow rise to the peak systole [26]. This phenomenon has been called the ''tarduseparvus'' effect.…”

Section: Distal Criteria (Indirect Evaluation Of the Stenosis)mentioning

confidence: 99%

Doppler ultrasound and renal artery stenosis: An overview

Granata

Fiorini²,

Andrulli

et al. 2009

Journal of Ultrasound

104

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KEYWORDSDoppler ultrasound; Ischemic nephropathy; Renal artery stenosis; Renovascular disease.Abstract Renovascular disease is a complex disorder, most commonly caused by fibromuscular dysplasia and atherosclerotic diseases. It can be found in one of three forms: asymptomatic renal artery stenosis (RAS), renovascular hypertension, and ischemic nephropathy. Particularly, the atherosclerotic form is a progressive disease that may lead to gradual and silent loss of renal function. Thus, early diagnosis of RAS is an important clinical objective since interventional therapy may improve or cure hypertension and preserve renal function. Screening for RAS is indicated in suspected renovascular hypertension or ischemic nephropathy, in order to identify patients in whom an endoluminal or surgical revascularization is advisable. Screening tests for RAS have improved considerably over the last decade. While captopril renography was widely used in the past, Doppler ultrasound (US) of the renal arteries (RAs), angio-CT, or magnetic resonance angiography (MRA) have replaced other modalities and they are now considered the screening tests of choice. An arteriogram is rarely needed for diagnostic purposes only. Color-Doppler US (CDUS) is a noninvasive, repeatable, relatively inexpensive diagnostic procedure which can accurately screen for renovascular diseases if performed by an expert. Moreover, the evaluation of the resistive index (RI) at Doppler US may be very useful in RAS affected patients for predicting the response to revascularization. However, when a discrepancy exists between clinical data and the results of Doppler US, additional tests are mandatory.Sommario La malattia nefrovascolare è un disordine complesso e le cause più comuni sono la malattia aterosclerotica e la displasia fibromuscolare. Classicamente si presenta in una delle seguenti tre forme: stenosi dell'arteria renale (SAR) asintomatica, associata a ipertensione nefrovascolare e/o con nefropatia ischemica. La SAR su base aterosclerotica è una malattia progressiva che può determinare in maniera asintomatica o paucisintomatica perdita graduale della funzione renale. Per tale motivo, la diagnosi precoce di SAR è un obiettivo clinico importante poiché la terapia interventistica può migliorare o curare l'ipertensione e preservare la funzione renale. Lo screening per SAR è indicato nel sospetto di ipertensione nefrovascolare o di nefropatia ischemica al fine di identificare i pazienti in cui è indicato un intervento di rivascolarizzazione. I test di screening per SAR sono migliorati considerevolmente durante l'ultimo decennio. Mentre la scintigrafia con test al captopril è stata utilizzata quasi esclusivamente nel passato, l'ecocolorDoppler delle arterie renali, l'angioTC e/o l'angioRM hanno sostituito le altre modalità di screening in molti centri. Per tale motivo l'arteriografia riveste sempre più un ruolo interventistico e solo di rado diagnostico. L'ecocolorDoppler è una procedura diagnostica non invasiva, ripetibile e relativamente economica che negli ultim...

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“…Attualmente l'ECD delle arterie renali risulta la principale metodica di screening nella diagnosi di stenosi della arteria renale con numerosi studi in ambito internazionale che attribuiscono a tale metodica valori di sensibilità pari all'83%-96% e di specificità del 76%-98% [5][6][7][8][9][10][11][12][13]. I vantaggi della metodica sono rappresentati dalla non invasività, ripetibilità, basso costo e buon valore predittivo negativo se eseguito in popolazione selezionata, mentre i limiti riconosciuti sono l'operatore-dipendenza, l'obesità, il meteorismo e le anomalie vascolari, con particolare riguardo alla presenza di varianti anatomiche dell'arteria renale [6,[13][14][15][16][17].…”

Section: Methodsunclassified

“…Color-Doppler ultrasonography (CDUS) of the renal arteries is the principal screening tool used to detect RAS, with many international studies reporting sensitivity and specificity values of 83%-96% and 76%-98%, respectively [5][6][7][8][9][10][11][12][13]. The advantages of the technique are its noninvasiveness, repeatability, low cost and good negative predictive value when used in selected populations, whereas its known limitations are operator dependence, obesity, bowel gas and vascular abnormalities, especially anatomical variants of the renal artery [6,[13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%