NCE-MRA与超声检查对比评估肾功能不全患者肾动脉狭窄程度的价值  

The Value of NCE-MRA and Ultrasound in Evaluating the Degree of Renal Artery Stenosis in Patients with Renal Insufficiency

作　　者：王甜 任晓璇 公维兴 孙力盟 WANG Tian;REN Xiaoxuan;GONG Weixing;SUN Limeng(Department of Radiology,Tai'an Traditional Chinese Medicine Hospital,Shandong 271000,China)

机构地区：[1]泰安市中医医院放射科,山东271000

出　　处：《影像技术》2024年第4期49-53,共5页Image Technology

摘　　要：目的:探讨非增强磁共振血管成像(NCE-MRA)与超声检查对比评估肾功能不全患者肾动脉狭窄(RAS)程度的价值。方法:收集2021年5月至2023年4月期间我院100例肾功能不全且疑似RAS患者的病例资料,所有患者均行NCE-MRA和超声检查,以选择性肾动脉造影(SRA)结果为金标准,分析NCE-MRA、超声检查和金标准对肾动脉狭窄诊断的一致性、诊断效能和对肾动脉不同狭窄程度的检出情况。结果:100例肾功能不全患者中,金标准检测出RAS(阳性)42例(42.00%),阴性58例(58.00%);42例肾动脉狭窄患者中,轻度9例(21.43%),中度18例(42.86%),重度12例(28.57%),管腔闭塞3例(7.14%);超声与金标准一致性一般(Kappa=0.628),NCE-MRA与金标准一致性较好(Kappa=0.857);NCE-MRA对肾功能不全患者RAS的敏感度、准确度高于超声检查(P<0.05),但二者的特异度、阴性预测值、阳性预测值对比无差异(P>0.05);超声、NCE-MRA对重度RAS、闭塞的检出准确率结果大致相符,但相较于超声而言,NCE-MRA对轻中度RAS的检出准确率更高。结论:与超声检查诊断肾功能不全患者相比,NCE-MRA特异度、准确度更高,更有利于肾动脉不同狭窄程度的检出。Objective:To explore the value of non enhanced magnetic resonance angiography(NCE-MRA)compared with ultrasound in evaluating the degree of renal artery stenosis(RAS)in patients with renal insufficiency.Methods:Data were collected from 100 patients with renal insufficiency and sus-pected RAS in our hospital from May 2021 to April 2023.All patients underwent NCE-MRA and ultra-sound examinations,using the results of selective renal artery angiography(SRA)as the gold standard.We analyzed the consistency,diagnostic efficacy,and detection of different degrees of renal artery steno-sis using NCE-MRA,ultrasound,and gold standard.Results:Among the 100 patients with renal insuffi-ciency,42(42.00%)were positive for RAS and 58(58.00%)were negative according to the gold standard;Among 42 patients with renal artery stenosis,9 were mild(21.43%),18 were moderate(42.86%),12 were severe(28.57%),and 3 were luminal occlusion(7.14%);The consistency between ultrasound and gold standard was moderate(Kappa=0.628),while the consistency between NCE-MRA and gold standard was good(Kappa=0.857);The sensitivity and accuracy of NCE-MRA for RAS in patients with renal insuffi-ciency were higher than those of ultrasound examination(P<0.05),but there was no difference in the specificity,negative predictive value,and positive predictive value between the two(P>0.05);The accu-racy of ultrasound and NCE-MRA in detecting severe RAS and occlusion is generally consistent,but com-pared to ultrasound,NCE-MRA has a higher accuracy in detecting mild to moderate RAS.Conclusion:Compared with ultrasound examination in diagnosing renal insufficiency patients,NCE-MRA has higher specificity and accuracy,which is more conducive to detecting different degrees of renal artery stenosis.

关 键 词：非增强磁共振血管成像 超声检查 肾功能不全 肾动脉狭窄程度 诊断效能 

分 类 号：R445[医药卫生—影像医学与核医学]