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Renal artery stenosis: analysis of Doppler waveform parameters and tardus-parvus pattern
M A Kliewer1, R H Tupler, B A Carroll
1Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Purpose:
The utility of Doppler parameters and waveform contour analysis for diagnosis of renal artery stenosis was studied in a hypertensive population screened for renovascular hypertension.
Materials And Methods:
The Doppler results were compared with those obtained with angiography in a prospective double-blind study involving 118 kidneys in 46 patients with hypertension and 11 potential renal donors with normal blood pressure. Doppler parameters measured in the distal renal artery included systolic acceleration, acceleration time, peak systolic velocity, deceleration in late systole, pulsatility and resistivity indexes, and waveform features in early systole.
Results:
Angiograms demonstrated 28 stenotic renal arteries. There was no significant difference between stenotic (> 50% diameter narrowing) and nonstenotic renal arteries for any parameters studied. When stenosis was further categorized as moderate (50%-79%) or severe (80%-95%), significant (P < .05) differences for acceleration time and systolic acceleration were found between nonstenotic and severely stenotic arteries.
Conclusion:
Doppler characterization of the tardus-parvus phenomenon in the distal renal artery is not an adequate screening method for detection of renal artery stenosis.