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Efficacy of echo-Doppler examination for the evaluation of renovascular disease

N Handa1, R Fukunaga, H Etani

  • 1First Department of Internal Medicine, Osaka University Medical School Hospital, Japan.

Ultrasound in Medicine & Biology
|January 1, 1988
PubMed

Insights

Noninvasive echo-Doppler velocimetry accurately diagnoses renal artery stenosis. This method, using the acceleration index (AI), shows high accuracy, sensitivity, and specificity compared to angiography.

Area of Science:

  • Nephrology
  • Radiology
  • Medical Imaging

Background:

  • Renal artery stenosis (RAS) is a significant cause of secondary hypertension and kidney disease.
  • Accurate diagnosis is crucial for timely intervention and improved patient outcomes.
  • Noninvasive diagnostic methods are preferred to avoid the risks associated with invasive procedures.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of noninvasive echo-Doppler velocimetry for renal artery stenosis.
  • To compare the accuracy of echo-Doppler velocimetry with conventional angiography.
  • To assess the utility of specific Doppler parameters (AI, AT, ATR) in diagnosing RAS.

Main Methods:

  • A comparative study involving 40 renal arteries with suspected stenosis.
  • Noninvasive diagnosis using duplex-Doppler velocimetry via a translumbar approach.
  • Angiography served as the gold standard for comparison.
  • Diagnosis based on acceleration index (AI), acceleration time (AT), and acceleration time ratio (ATR).

Main Results:

  • High technological success rate (98%) achieved with the translumbar echo-Doppler approach.
  • Echo-Doppler velocimetry demonstrated 95% accuracy, 100% sensitivity, and 93% specificity for significant RAS when using the AI criterion.
  • Established normal ranges for AI (≥3.78), AT (≤0.07 s), and ATR (≤1.35) from 11 control subjects.

Conclusions:

  • Noninvasive echo-Doppler velocimetry, particularly using the acceleration index, is a highly accurate method for diagnosing significant renal artery stenosis.
  • This technique offers excellent sensitivity and specificity, making it a valuable screening tool.
  • The translumbar approach ensures high success rates for signal acquisition.

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