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Titolo:
Can MR measurement of renal artery flow and renal volume predict the outcome of percutaneous transluminal renal angioplasty?
Autore:
Binkert, CA; Debatin, JF; Schneider, E; Hodler, J; Ruehm, SG; Schmidt, M; Hoffmann, U;
Indirizzi:
Univ Zurich Hosp, Dept Radiol, CH-8091 Zurich, Switzerland Univ Zurich Hosp Zurich Switzerland CH-8091 CH-8091 Zurich, Switzerland
Titolo Testata:
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
fascicolo: 4, volume: 24, anno: 2001,
pagine: 233 - 239
SICI:
0174-1551(200107/08)24:4<233:CMMORA>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENOVASCULAR HYPERTENSION; BALLOON ANGIOPLASTY; RANDOMIZED TRIAL; NATURAL-HISTORY; BLOOD-FLOW; STENOSIS; ANGIOGRAPHY; DISEASE; ULTRASONOGRAPHY;
Keywords:
cine phase-contrast MR; volume measurement MR; renal artery stenosis; kidney;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Binkert, CA Oregon Hlth Sci Univ, Charles Dotter Inst Intervent Therapy, 3181 SW Sam Jackson Pk Rd,L-605, Portland, OR 97201 USA Oregon Hlth Sci Univ3181 SW Sam Jackson Pk Rd,L-605 Portland OR USA 97201
Citazione:
C.A. Binkert et al., "Can MR measurement of renal artery flow and renal volume predict the outcome of percutaneous transluminal renal angioplasty?", CARDIO IN R, 24(4), 2001, pp. 233-239

Abstract

Purpose: Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA. Methods: The data on 23 patients (13 men, 10 women; age range 47-82 years,mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure > 15% or (b) a reduction in serum creatinine > 20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm(3)). Results: Clinical success was observed in 11 patients. Twelve patients didnot benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm(3) predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5ml/min/cm(3) identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p < 0.001). Conclusion: A combination of cine phase-contrast MR renal flow and parenchymal volume measurements enables identification of patients benefiting fromPTRA with a high sensitivity and NPV, but only moderate specificity and PPV.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 12:43:35