Detection of renal artery stenosis: prospective comparison of captopril-enhanced Doppler sonography, captopril-enhanced scintigraphy, and MR angiography.

Details

Serval ID
serval:BIB_52FD2E1E3C13
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Detection of renal artery stenosis: prospective comparison of captopril-enhanced Doppler sonography, captopril-enhanced scintigraphy, and MR angiography.
Journal
AJR: American journal of roentgenology
Author(s)
Qanadli S.D., Soulez G., Therasse E., Nicolet V., Turpin S., Froment D., Courteau M., Guertin M.C., Oliva V.L.
ISSN
0361-803X
Publication state
Published
Issued date
11/2001
Peer-reviewed
Oui
Volume
177
Number
5
Pages
1123-9
Language
english
Abstract
OBJECTIVE: The objective of our study was to compare the value of captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, and gadolinium-enhanced MR angiography for detecting renal artery stenosis. SUBJECTS AND METHODS: Forty-one patients with suspected renovascular hypertension were prospectively examined with captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, gadolinium-enhanced MR angiography, and catheter angiography. The sensitivity and specificity of each technique for detecting renal artery stenosis measuring 50% or greater and 70% or greater were compared using the McNemar test. Positive and negative predictive values were estimated for populations with 5% and 30% prevalence of renal artery stenosis. Kappa values for interobserver agreement were assessed for both gadolinium-enhanced MR angiography and catheter angiography. RESULTS: For detecting renal artery stenosis measuring 50% or greater, the sensitivity of gadolinium-enhanced MR angiography (96.6%) was greater than that of captopril-enhanced Doppler sonography (69%, p = 0.005) and captopril-enhanced renal scintigraphy (41.4%, p = 0.001). No significant difference in specificity was observed among modalities. For renal artery stenosis measuring 50% or greater, positive and negative predictive values were respectively 62% and 86% for captopril-enhanced Doppler sonography, 49% and 76% for captopril-enhanced renal scintigraphy, and 53% and 98% for gadolinium-enhanced MR angiography. Interobserver agreement was high for both gadolinium-enhanced MR angiography (kappa = 0.829) and catheter angiography (kappa = 0.729). CONCLUSION: Gadolinium-enhanced MR angiography is the most accurate noninvasive modality for detecting renal artery stenosis greater than or equal to 50%. The use of captopril-enhanced Doppler sonography in combination with gadolinium-enhanced MR angiography for identifying renal artery stenosis needs to be evaluated with a cost-effectiveness analysis.
Keywords
Adult, Aged, Angiography, Captopril/diagnostic use, Female, Humans, Hypertension, Renovascular/diagnosis, Image Enhancement, Magnetic Resonance Angiography, Male, Middle Aged, Observer Variation, Prospective Studies, Radioisotope Renography, Renal Artery Obstruction/diagnosis, Sensitivity and Specificity, Technetium Tc 99m Mertiatide/diagnostic use, Ultrasonography, Doppler
Pubmed
Web of science
Create date
09/04/2008 16:12
Last modification date
20/08/2019 14:08
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