[Duplex ultrasonographic diagnosis of renal artery stenosis by intrarenal acceleration determination and recognition of the tardus-parvus phenomenon with special regard to multiple renal arteries].
OBJECTIVE
Use of the "tardus and parvus" abnormalities for the exclusion of significant renal artery stenosis, including multiple renal arteries.


METHODS
The lobar and interlobar renal arteries of 50 hypertensive patients were examined by colour duplex sonography at three different levels. Analysis included determination of the early systolic acceleration time and evaluation of the early diastolic complexes. In all patients, intra-arterial catheter angiography was performed on the following day.


RESULTS
48 out of the 50 colour duplex examinations could be properly evaluated. Angiography showed that 21 patients (42%) had multiple renal arteries, in 13 there was a haemodynamically significant renal artery stenosis and amongst these 4 patients had bilateral renal artery stenoses. The sensitivity and specificity of the early systolic acceleration time at > or = 0.120 sec. was 77 and 46% respectively. Amongst the 17 haemodynamically significant stenoses shown by angiography, 10 demonstrated changes in the early systolic peaks of the Doppler spectrum, a sensitivity of 69% and specificity of 90%.


CONCLUSIONS
Use of acceleration time and of the early systolic complexes cannot be recommended as sole methods during a screening procedure.
Strunk
H
H
Klinik mit Poliklinik für Radiologie, Universitätskliniken Mainz.
Jaeger
U
U
D000328:Adult; D000368:Aged; D000792:Angiography; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods
Duplexsonographischer Nachweis von Nierenarterienstenosen mittels intrarenaler Akzelerationszeitbestimmung und Erfassung des Tardus-parvus-Phänomens unter besonderer Berücksichtigung von Mehrfachversorgungen.