title: The clinical role of contrast-enhanced ultrasound in the evaluation of renal artery stenosis and diagnostic superiority as compared to traditional echo-color-Doppler flow imaging.
abstract: OBJECTIVE
  The purpose of this study was to investigate the feasibility of contrast-enhanced ultrasound (CEUS) in the evaluation of renal artery stenosis as compared with traditional techniques: echo color Doppler (ECD) investigation and selective angiography .CEUS is a technique based on the injection of an intravascular biocompatible tracer, namely an intravenous contrast galactose microparticle suspension containing microbubbles (Levovist), that has a similar rheology to that of red blood cells, allowing quantification of renal tissue perfusion.
  
  
  METHODS
  A population of 120 hypertensive patients (82 men, mean age 55) with a systolic abdominal murmur and/or a diagnosis of poly-districtual atherosclerosis was studied by ECD and CEUS (Levovist). Selective angiography was performed in patients with renal artery stenosis demonstrated by one of the two ultrasonographic techniques.
  
  
  RESULTS
  Forty of the 120 patients in the study population showed renal artery stenosis at one of the two ultrasound techniques: ECD identified renal artery stenosis in 33 cases and CEUS in 38. Instead, selective angiography had detected renal artery stenosis in 38 patients, the same with renal artery stenosis diagnosed by CEUS. Thus, CEUS sensitivity, specificity and accuracy were similar to those of angiography while six false negatives and two false positives were obtained with ECD.
  
  
  CONCLUSIONS
  Our results suggest that this renal CEUS is a promising, new, non-invasive method for screening patients with suspected renal artery stenosis. This technique appears to be superior to traditional ECD flow imaging for diagnosing renal artery stenosis and so may be an important aid in cardiovascular diagnostics.
authors.affiliation: Section of Cardiovascular Disease, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Italy. ciccone@cardio.uniba.it
authors.forename: M M
authors.initials: MM
authors.lastname: Ciccone
authors.forename: F
authors.initials: F
authors.lastname: Cortese
authors.forename: A
authors.initials: A
authors.lastname: Fiorella
authors.forename: P
authors.initials: P
authors.lastname: Scicchitano
authors.forename: F
authors.initials: F
authors.lastname: Cito
authors.forename: G
authors.initials: G
authors.lastname: Quistelli
authors.forename: G
authors.initials: G
authors.lastname: Pertosa
authors.forename: R
authors.initials: R
authors.lastname: D'Agostino
authors.forename: P
authors.initials: P
authors.lastname: Guida
authors.forename: S
authors.initials: S
authors.lastname: Favale
mesh_terms: D003287:Contrast Media / Q000008:administration & dosage; D005188:False Negative Reactions; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007558:Italy; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508