How to diagnose renal artery stenosis correctly using ultrasound? Evaluation of results of renal arteries duplex ultrasonography examinations

Zhu, Rong; Zhang, Qi; Ye, We; Wang, Jian; Kong, Jing; Jin, Jin; Li, Jianchu

doi:10.11152/mu-1341

Cited by 11 publications

(19 citation statements)

References 30 publications

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“…Acceleration time (AT) is one of the presence of injure Doppler waveform and a slow rise to peak systole in spectral Doppler of the interlobar artery, and it is commonly used as an indirect indicator for the diagnosis of renal artery stenosis, acute renal failure, and transplant rejection( 18 Li et al, 2008;19-20 Wong et al, 1989; 21 Bardelli et al, 2006; 22 Ripolles et al, 2001). This phenomenon is called "Tardus-parvus" effect( 23 Zhu et al, 2018). Tardus means slow and late and Parvus means small and little.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value Of Doppler Ultrasound In Early Chronic Kidney Disease

Huang

Tao

et al. 2021

Preprint

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Objective: To explore of ultrasound combined with renal pathology score, and compare the application value of elastography, two-dimensional (2D) ultrasound, three-dimensional（3D） ultrasound and other ultrasound imaging methods in early chronic kidney diagnosis.Methods: Combined ultrasound and pathological scores. A retrospective analysis of 118 patients with chronic kidney disease examined in the department of nephrology of the author's hospital. 36 healthy who were normal in the same period were selected as the control group. Combined with the left kidney pathology score and multi-factor logistic regression analysis to evaluate independent predictors of early pathological injured in CKD, ROC curve analysis to evaluate the diagnostic efficacy of each ultrasound index. Statistical evaluation: The difference was statistically significant (P <0.05).Results: In patients with severely injured CKD, renal length, three-dimensional kidney volume, Renal interlobar artery RI, and AT all appear to be effective predictors. Among patients with moderate injured, only AT and RI were effective predictors. Among patients with mildly impaired CKD, AT has the highest diagnostic efficacy, but SWV has the highest sensitivity (83.8%) for detecting mild renal injured. The results confirm that the Renal interlobar artery AT is the strongest independent predictor of CKD injured.Conclusion: The results confirm that the Renal interlobar artery AT is the strongest independent predictor of CKD injured.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value Of Doppler Ultrasound In Early Chronic Kidney Disease

Huang

Tao

et al. 2021

Preprint

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“…[31][32][33][34] However, TRAS misdiagnosis can occur when considering the PSV alone, leading to unnecessary angiographic evaluation. [22][23][24] Therefore, it is paramount to establish a normal RAA PSV to guide the diagnosis of graft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the RAA-to-EIA ratio, the abnormal value is usually 1.8 to 2, though this finding is controversial. [22][23][24][25] Nonetheless, the normal range of PSV in renal transplants without clinical suspicion for TRAS is not well established. According to multiple authors, this velocity can range from 130 to 300 cm/s.…”

mentioning

confidence: 99%

Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

Luna¹,

Hassan²,

Scortegagna³

et al. 2021

Journal of Diagnostic Medical Sonography

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Objective: The primary purpose is to define the mean renal artery anastomosis peak systolic velocity (RAA PSV) and the renal artery anastomosis to external iliac artery ratio (RAA-to-EIA) of renal transplant recipients without graft dysfunction. Moreover, to determine associations with type of vascular anastomosis and type of graft. Materials and Methods: This is a single-center retrospective analysis of kidney transplant recipients. Recorded variables included recipient age, type of vascular anastomosis, type of graft, RAA PSV, and external iliac artery PSV (EIA PSV). Such variables were evaluated on different postoperative follow-up periods. Results: There was a high degree of reliability between the RAA PSV and EIA PSV ( P < .001). The mean RAA PSV was 174 cm/s ± 72.9 cm/s with 95% confidence interval (CI) (162.2 cm/s-185.5 cm/s]. Conclusion: This study highlights the importance of determining the normal range of RAA PSV and showed that a high PSV does not necessarily indicate dysfunction.

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“…An independent observer measured, on recorded B‐mode images and Doppler signals, peak systolic flow velocity (PSV) and end‐diastolic flow velocity (EDV), 8,9 and the resistance index (RI) was automatically calculated as (PSV‐EDV)/PSV 10 . Acceleration time (AT) and acceleration index (AI) were measured from the foot to the apex of the early systolic peak 11 . If the foot of the early systolic peak could not be recognized, the end point of the downslope slope of the previous cardiac cycle was used (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…10 Acceleration time (AT) and acceleration index (AI) were measured from the foot to the apex of the early systolic peak. 11 If the foot of the early systolic peak could not be recognized, the end point of the downslope slope of the previous cardiac cycle was used ( Figure 2). PSV, EDV, and RI were measured in the left and right renal arteries during natural and deep-inspiration breath-holding, and the anatomic angle between the initial segment of the renal artery trunk and the distal end of the abdominal aorta in each corresponding respiratory phase was measured ( Figure 3).…”

Section: Measurementsmentioning

confidence: 99%

Impact of different conditions of breath‐holding on the results of renal artery Doppler sonography: A pilot study

Zhang

Wang

et al. 2020

J of Clinical Ultrasound

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Purpose: To investigate the impact of different breath-holding conditions on the results of renal artery Doppler ultrasonography (RADS). Methods:In 45 healthy volunteers, we performed RADS examination during breathholding while breathing naturally and after a deep inspiration. We measured and compared peak systolic flow velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the right (RRA) and left (LRA) renal artery, and PSV, EDV, RI, acceleration time and acceleration index (AI) of the right and left interlobar arteries.Results: The RRA and LRA PSV were, respectively, 76 ± 13 cm/s and 77 ± 15 cm/s under natural breathing and 93 ± 18 cm/s and 89 ± 24 cm/s after deep inspiration (P ≤ .001). The RRA and LRA EDV were also greater at deep inspiration (P < .001 and P = .019, respectively). There was no significant difference in RRA or LRA RI. The PSV, RI, and AI of the right and left interlobar arteries were greater after deep inspiration (P ≤ .001), without difference in AI. Conclusion: Breath-holding conditions may influence Doppler measurements of renal artery flow velocity and should be reported and taken into account. K E Y W O R D S breath-holding, Doppler ultrasonography, renal artery

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How to diagnose renal artery stenosis correctly using ultrasound? Evaluation of results of renal arteries duplex ultrasonography examinations

Abstract: Our study indicates that standard operating procedures and improvements in examination technique by ultrasound doctors could reduce the discordance between multiple tests.

Cited by 11 publications

References 30 publications

Diagnostic Value Of Doppler Ultrasound In Early Chronic Kidney Disease

Diagnostic Value Of Doppler Ultrasound In Early Chronic Kidney Disease

Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

Impact of different conditions of breath‐holding on the results of renal artery Doppler sonography: A pilot study

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