Renal artery stenosis: prospective evaluation of diagnosis with color duplex US compared with angiography. Work in progress.

Berland, Lincoln L.; Koslin, D B; Routh, William D.; Keller, F. S.

doi:10.1148/radiology.174.2.2404314

Cited by 170 publications

(75 citation statements)

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“…Some investigators report remarkable success, while others have reported dismal results in large unselected patient groups. 15,16 A recent study declared duplex ultrasound to be most valuable not only in the screening for renal artery disease but also to estimate its functional significance by means of determination of the resistive index. 17 The duplex ultrasound performance in this study, however (ie, sensitivity 97%; specificity 98%), was derived from a previous report by the same authors in a selected group of patients with a high prevalence of renovascular disease (58%).…”

Section: Discussionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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The aim of this study was to evaluate the accuracy of duplex ultrasound for the diagnosis of renovascular disease in a cohort of hypertensive patients. In 78 patients suspected of renovascular hypertension on clinical grounds duplex ultrasound examination of the renal arteries was performed. Renal angiography was used as the standard of reference. Duplex ultrasound was inconclusive in 11 kidneys (7%). None of the supernumerary renal arteries was detected with duplex ultrasound. The overall prevalence of significant renovascular disease (у50% stenosis) was 20%. Based on the combination of parameters at thresholds commonly applied in current literature: ie PSV max Ͼ180 cm/sec and RAR Ͼ3.5 the overall sensitivity of duplex ultrasound for detection of haemodynamically significant renovascular disease was 50.0% with a specificity of 91.3% (PPV: 87.9%; NPV:

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Section: Discussionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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“…Authors, who considered a velocity > 100 cm/s as a parameter, had low accuracy indices, but a high index of inconclusive examinations, denoting individual technical limitations in the study of the renal arteries on vascular color Doppler ultrasound 8,9 .…”

Section: Discussionmentioning

confidence: 99%

O papel da ultra-sonografia vascular com Doppler colorido na avaliação da hipertensão reno-vascular: acurácia da técnica direta de avaliação das artérias renais

Engelhorn

Pullig

2004

Arq. Bras. Cardiol.

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477The early diagnosis of patients suspected of having renovascular hypertension is important because of the risk of progression to renal insufficiency due to the nephropathic ischemia caused by lesions limiting the renal artery flow.The diagnosis of arterial hypertension resulting from renal artery stenosis may be established with the following different complementary examinations: determination of selective renin in the renal vein; functional study with radioisotopes; excretory urography; determination of the peripheral renin stimulated with captopril; magnetic angioresonance; angiography; and, more recently, vascular color Doppler ultrasound.Arteriography is the most precise method for diagnosing renal artery stenosis, but it has some limitations, such as allergic reaction and the risk of nephrotoxicity due to the contrast medium, in addition to complications inherent to the procedure and its high cost. Another important factor is that arteriography is an anatomic study, and, therefore, does not provide hemodynamic information about the renal lesions.This study aimed at assessing the accuracy of vascular color Doppler ultrasound as compared with that of arteriography in identifying hemodynamically significant renal artery stenoses. MethodsWe carried out a prospective double-blind study at the Noninvasive Vascular Laboratory of the Hospital de Caridade of the Santa Casa de Misericórdia de Curitiba/PUCPR, to assess the accuracy of vascular color Doppler ultrasound in the diagnosis of stenotic or obstructive lesions in the renal arteries as compared with that of arteriography, which is considered the gold standard.One hundred and thirty-seven renal arteries from 69 adult patients (30 men and 39 women) suspected of having renovascular arterial hypertension, with no distinction of complexion or biotype, and a mean age of 54 years were studied. One of the patients had undergone nephrectomy prior to the study.The following patients with arterial hypertension of recent onset were included in the study: young individuals with no familial history of hypertension; individuals > 55 years with arterial hypertension of recent onset or abrupt lack of control; hypertensive individuals refractory to treatment; hypertensive individuals with an abdominal murmur; and individuals with predominantly diastolic arterial hypertension (> 120 mmHg). Patients with the following characteristics were excluded from the study: previous diagnosis of renal artery lesion; history of allergy to iodinated contrast me- ObjectiveTo assess the accuracy of vascular color Doppler ultrasound as compared with digital subtraction arteriography for identifying hemodynamically significant renal artery stenoses. MethodsOne hundred and thirty-seven renal arteries from 69 adult patients suspected of having renovascular arterial hypertension were prospectively studied with ultrasound. The results obtained were compared in a double-blind manner with those obtained on digital subtraction arteriography, and the following parameters were calculated according to ...

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“…Experienced operators can achieve sensitivities of up to 95% for the detection of RAS (24). However, US is very operator dependent and has, therefore, a relatively high interobserver variability and a low sensitivity when performed by a nonexperienced operator (25,26). Additionally, it often fails in obese patients or those with bloated small or large bowl.…”

Section: Current Position: Indications For Imaging and Imaging Technimentioning

confidence: 99%

Renovascular imaging in the NSF Era

Roditi

Maki

Oliveira

et al. 2009

Magnetic Resonance Imaging

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The detection of the association between nephrogenic systemic fibrosis (NSF), a rare but potentially life‐threatening disease only encountered in patients with severely impaired renal function, and the previous administration of some Gd‐chelates has cast a shadow on the administration of Gd‐chelates in patients with chronic renal failure. So far, contrast‐enhanced MR‐angiography (MRA) was considered the best diagnostic modality in patients with suspected renal disease. This review explores the most appropriate use of renal MRA with a focus on newly developed nonenhanced MRA techniques. Nonenhanced MRA techniques mainly based on SSFP with ECG‐gating allow for acceptable spatial resolution to visualize at least the proximal parts of the renal arteries. In addition functional renal imaging techniques and their current clinical role are critically appreciated. J. Magn. Reson. Imaging 2009;30:1323–1334. © 2009 Wiley‐Liss, Inc.

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Renal artery stenosis: prospective evaluation of diagnosis with color duplex US compared with angiography. Work in progress.

Cited by 170 publications

References 0 publications

Renovascular disease in patients with hypertension: detection with duplex ultrasound

Renovascular disease in patients with hypertension: detection with duplex ultrasound

O papel da ultra-sonografia vascular com Doppler colorido na avaliação da hipertensão reno-vascular: acurácia da técnica direta de avaliação das artérias renais

Renovascular imaging in the NSF Era

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