Evaluation of colour duplex ultrasound scanning in diagnosis of renal artery stenosis, compared to angiography: a prospective study on 53 patients.

Abstract

To evaluate the accuracy of colour Duplex ultrasound scanning compared to angiography in the diagnosis of renal artery stenosis. A prospective study. A selected series of 53 unselected patients, who had both sonography and angiography. Sonographic examinations were performed by the same operator, who was unaware of angiographic results. Angiography was interpreted without knowledge of the sonographic findings. Peak systolic velocity and acceleration time were sonographic criteria. In contrast to the other studies, inadequate examinations were not repeated, nor drawn out from analysis. On 112 arteries visualised by angiography, 103 were detected by sonography. Feasibility was 78.6% for complete examinations. On 16 stenoses identified by angiography, 12 were detected by sonography, leading to a 75.0% sensitivity and a 100% specificity. This study was elaborated with a pragmatic attitude similar to clinical practice, and the results achieved were equal to those of other series. Accessory arteries are poorly visualised; limits of this technique are due to the operator's training and patient's poor condition for undergoing sonographic examination. These limiting factors mean a loss of sensitivity, which precludes a diagnostic decision, when the result is negative.