Abstract
Objective This study is aimed at exploring the accuracy of contrast-enhanced ultrasound (CEUS) in grading renal artery stenosis. Methods 122 renal arteries with suspected renal artery stenosis were selected. DSA, DUS, and CEUS were performed for all patients with suspected renal artery stenosis in the research. DSA was selected as the gold standard. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of CEUS or Doppler ultrasound (DUS) in the diagnosis of renal artery stenosis were analyzed. The consistency between CEUS and digital subtraction angiography (DSA) was compared. The accuracy of DUS or CEUS in grading renal artery stenosis was assessed by the area under the receiver operating characteristic (ROC) curves and compared between groups. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CEUS in the diagnosis of renal artery stenosis were 88.9%, 87.8%, 88.5%, 93.5%, and 80.0%, respectively. There was no significant difference in grading renal artery stenosis between CEUS and DSA (X2 = 0.643, P = 0.424). 77 of the 122 renal arteries were diagnosed with the stenosis rate more than 30% by CEUS. Compared with the results of DSA, the kappa value of CEUS was 0.749 (P < 0.05). Conclusion CEUS is accurate in grading renal artery stenosis, and it may represent the method of choice in diagnosing renal artery stenosis.
Highlights
Renal artery stenosis elicits complex biological responses, and it often develops progressively [1, 2]
digital subtraction angiography (DSA) was selected as the gold standard for the diagnosis of renal artery stenosis, and it was performed for all patients with suspected renal artery stenosis in the research
DSA: digital subtraction angiography; CEUS: contrast-enhanced ultrasound; DUS: Doppler ultrasound. ∗There was a significant difference in grading renal artery stenosis between DUS and DSA (P = 0:043). ∗∗There was no significant difference in grading renal artery stenosis between CEUS and DSA (P = 0:424)
Summary
Renal artery stenosis elicits complex biological responses, and it often develops progressively [1, 2]. Serious health complications such as secondary hypertension, stroke, myocardial infarction, renal failure, and even death can be caused by renal artery stenosis [3,4,5]. DSA remains the gold standard for the diagnosis of renal artery stenosis [17, 18]. The reliance on nephrotoxic contrast agents limits the use of DSA. It is usually not the first choice in clinical practice. In patients with renal artery stenosis, multiple follow-up reviews are needed to determine the (a)
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