Renal artery stenosis: analysis of Doppler waveform parameters and tardus-parvus pattern.
OBJECTIVE
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.


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.


CONCLUSIONS
Doppler characterization of the tardus-parvus phenomenon in the distal renal artery is not an adequate screening method for detection of renal artery stenosis.
Kliewer
M A
MA
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Tupler
R H
RH
Carroll
B A
BA
Paine
S S
SS
Kriegshauser
J S
JS
Hertzberg
B S
BS
Svetkey
L P
LP
D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012079:Renal Circulation / Q000502:physiology; D014465:Ultrasonics; D014463:Ultrasonography