Can Levovist-enhanced Doppler ultrasound replace angiography in renal arteries imaging?
BACKGROUND
To evaluate the diagnostic efficacy of ultrasound imaging of renal arteries after Levovist administration.


METHODS
During a 20-month period, 100 hypertensive patients with suspected renal artery stenosis were referred to the Department of Interventional Radiology. In all patients, angiography and ultrasound examinations of renal arteries were performed (100 right, 100 left and 23 additional), before and after Levovist injection, using color and spectral Doppler. Results of Doppler examinations before and after Levovist administration were compared with results of angiography ('gold standard '). Hemodynamically significant renal artery stenoses (> 50% in angiography)were diagnosed following Doppler parameters: Vmax > 2 m/s, V min > 1.5 m/s, RAR > 3.5, acceleration time > 0.08 s.


RESULTS
The diagnostic efficacy of Doppler examinations of the right renal artery (RRA)increased from 68% before to 98% after Levovist enhancement and diagnostic efficacy for the left renal artery (LRA) increased from 61% to 97%. In conventional study, 7 additional renal arteries (30.4%) were visualized, after Levovist administration this number increased to 15 (65.2%). Before Levovist injection, 3 stenoses of RRA and 1 stenosis of LRA were diagnosed. After Levovist enhancement, the number of RRA stenoses increased to 5 and that of LRA stenoses increased to 2, later confirmed by angiography.


CONCLUSIONS
The use of Levovist increases the diagnostic efficacy of Doppler ultrasound examinations of renal arteries and makes it comparable to angiography.
Drelich-Zbroja
Anna
A
Department of Interventional Radiology and Neuroradiology, University School of Medicine in Lublin, Lublin, Poland. zbroanna@interia.pl
Jargiełło
Tomasz
T
Szymańska
Anna
A
Krzyzanowski
Wojciech
W
Szczerbo-Trojanowska
Małgorzata
M
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011237:Predictive Value of Tests; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508