Journal of the Chinese Medical Association
Volume 73, Issue 6 , Pages 300-307, June 2010

Magnetic Resonance Angiography and Doppler Scanning for Detecting Atherosclerotic Renal Artery Stenosis

  • Yee-Yung Ng

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Yee-Yung Ng, Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital, National Yang-Ming University, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Shu-Huei Shen

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Hsin-Kai Wang

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Hsiuo-Shan Tseng

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Rheun-Chuan Lee

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Shiao-Chi Wu

      Affiliations

    • Institute of Health and Welfare Policy, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 21 September 2009; accepted 25 May 2010.

Article Outline

Background

Atherosclerotic renal artery stenosis (ARAS) is a progressive but potentially reversible chronic kidney disease. Although the high sensitivity and specificity of renal Doppler scanning (RDS) for ARAS has been reported in western countries, ARAS has not been detected by RDS. This study used magnetic resonance angiography (MRA) to evaluate the sensitivity and specificity of RDS for detecting ARAS among outpatients at a nephrology clinic, and to calculate the degree of underestimation of ARAS by RDS.

Methods

A total of 257 outpatients, aged > 50 years were examined for ARAS by RDS and MRA.

Results

Thirty-seven (14.4%) and 139 (54.1%) of 257 patients had stenosis detected by RDS and MRA, respectively. Among the 220 patients whose RDS results were negative, MRA detected stenosis in 111 (50.45%). Multivariate logistic regression analysis showed that age > 65 years, duration of smoking, coronary artery disease, and serum creatinine levels > 354 mmol/L (4 mg/dL) were significant and independent factors that influenced ARAS in patients with negative results by RDS.

Conclusion

RDS might still be the diagnostic procedure of choice for screening outpatients for ARAS because it is inexpensive, convenient, able to detect severity, and avoids the use of contrast media. When RDS is negative in aged people who have smoked longer than 20 years, with coronary artery disease or serum creatinine > 4 mg/dL, MRA is recommended for further evaluation of ARAS.

Key Words:  Doppler scanning , magnetic resonance angiography , renal artery stenosis

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PII: S1726-4901(10)70065-4

doi:10.1016/S1726-4901(10)70065-4

Journal of the Chinese Medical Association
Volume 73, Issue 6 , Pages 300-307, June 2010

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