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Ultrasonography |
1 From the University Research Unit B-1068 (Physiopathologic and therapeutic mechanisms of cardiac insufficiency) and the Department of Radiology, Hôpital de Brabois, 54511 Vandoeuvre les Nancy, France (M.C.); the Department of Arterial Hypertension, Hôpital Broussais, Paris, France (P.F.P.); the Department of Radiology, West Glasgow Hospitals University National Health Service Trust, UK (G.M.B.); and Schering, Lys les Lannoz, France (T.R., D.M.D.). From the 1997 RSNA scientific assembly. Received January 15, 1999; revision requested March 1; final revision received May 25; accepted July 23. Supported by a grant from Schering, Berlin, Germany. Address reprint requests to M.C. (e-mail: Michel.Claudon@wanadoo.fr).
PURPOSE: To assess SH U 508A in the diagnosis of suspected renal arterial stenosis by means of ultrasonography (US) and to confirm the safety of SH U 508A in a clinical setting.
MATERIALS AND METHODS: A randomized crossover study was performed in 198 patients from 14 European centers who were referred for renal arterial angiography because they were suspected of having renal arterial stenosis. All patients underwent nonenhanced and SH U 508A–enhanced Doppler US of the renal arteries. Doppler criteria included measurement of renal arterial peak systolic velocity (threshold, 1.4–2.0 m/sec) in all centers and renoaortic ratio (threshold, 3.0–3.5) in nine.
RESULTS: The number of examinations with successful results increased following enhanced Doppler US examination—160 (83.8%) compared with 122 (63.9%) with nonenhanced Doppler US (P = .001), including patients with obesity or renal dysfunction. Renal arterial stenosis (
50%) was detected at angiography in 72 patients. Results at enhanced Doppler US were in agreement with results at angiography more often than with results at nonenhanced Doppler US in the diagnosis or exclusion of renal arterial stenosis (P = .001). For patients examined with nonenhanced and enhanced Doppler US, sensitivity (80.0% and 83.7%, respectively) and specificity (80.8% and 83.6%, respectively) remained unchanged. There were no clinically important adverse events following use of SH U 508A.
CONCLUSION: In patients suspected of having renal arterial stenosis, SH U 508A increased the number of diagnostic renal arterial Doppler studies.
Index terms: Hypertension, renovascular, 961.721 • Renal arteries, stenosis or obstruction, 961.72 • Renal arteries, US, 961.12983, 961.12988 • Ultrasound (US), contrast media, 961.12988 • Ultrasound (US), Doppler studies, 961.12983, 961.12988
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