Evaluation of the tardus-parvus pattern in patients with atherosclerotic and nonatherosclerotic renal artery stenosis.
OBJECTIVE
The aim of this study was to evaluate the differences in the tardus-parvus pattern between atherosclerotic and nonatherosclerotic renal artery stenosis (RAS) and to explore the causes of these differences.


METHODS
In 81 patients, including a nonatherosclerotic group (29 cases of Takayasu arteritis and 22 cases of fibromuscular dysplasia) and an atherosclerotic group (n = 30), RAS was detected by color Doppler sonography and confirmed by renal arteriography. Doppler spectra were obtained at the upper, middle, and lower pole interlobar arteries, and the one with the most prolonged acceleration time (AT) was selected for recording the AT and resistive index (RI).


RESULTS
Renal angiography revealed 16 moderate RASs, 80 severe RASs, and 15 occlusions. No statistically significant differences were found in the AT between the atherosclerotic and nonatherosclerotic groups in the mild (P = .24), moderate (P = .63), and severe stenotic (P = .41) subgroups; however, there were statistically significant differences in the RI between the atherosclerotic and nonatherosclerotic groups in the mild (P < .001), moderate (P < .01), and severe (P < .001) subgroups. The RI values in the atherosclerotic group were much higher than those in the nonatherosclerotic group for the 3 stenotic subgroups.


CONCLUSIONS
The AT measurement method used widely now cannot differentiate potential differences in pulsus-tardus waveforms between atherosclerotic and nonatherosclerotic RAS; however, it remains a useful approach to detect RAS. Different RI cutoff values should be established according to atherosclerotic and nonatherosclerotic RAS, and consideration of influencing factors for the RI will help reduce misdiagnosis.
Li
Jian-chu
JC
Department of Ultrasonography, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Wangfujing, 100730 Beijing, China. jianchu.li@163.com
Yuan
Yan
Y
Qin
Wei
W
Wang
Lei
L
Dai
Qing
Q
Qi
Zhen-hong
ZH
Meng
Hua
H
Cai
Sheng
S
Jiang
Yu-xin
YX
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D005260:Female; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging* / Q000473:pathology; D018615:Ultrasonography, Doppler, Color