南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (01): 84-.

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非对比剂增强肾动脉MRA诊断老年肾动脉狭窄的可行性

徐 贤，安宁豫，陈穗惠，李 雪，江 波，韩邵君，刘新球   

  • 出版日期:2014-01-20 发布日期:2014-01-20

Feasibility of non-contrast enhanced magnetic resonance angiography for diagnosis of
renal artery stenosis in elderly patients

  • Online:2014-01-20 Published:2014-01-20

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摘要： 目的评估流入反转恢复稳态自由进动（IFIR-FIEASTA）序列诊断老年患者肾动脉狭窄的效能。方法对27例老年患者进
行三维对比增强磁共振血管成像（3D CE-MRA）和IFIR-FIEASTA扫描，比较两种检查方法的图像质量，采用Kappa分析检验
IFIR-FIEASTA和CE-MRA诊断肾动脉狭窄的一致性。以CE-MRA为金标准，评估IFIR-FIEASTA诊断肾动脉狭窄的敏感度、
特异度、准确率、阳性预测值和阴性预测值。结果两种检查方法的图像质量均100%达到诊断要求，但CE-MRA的图像质量显
著优于IFIR-FIEASTA。CE-MRA和IFIR-FIEASTA诊断肾动脉狭窄的一致性好；IFIR-FIEASTA诊断肾动脉狭窄的敏感度、特
异度、准确率、阳性预测值和阴性预测值分别为97.1%、100%、98.1%、100%和95%。结论IFIR-FIEASTA诊断老年患者肾动脉
狭窄的可行性很高，临床实用性强。

Abstract: Objective To evaluate the diagnostic efficacy of IFIR-FIESTA technique in detecting renal artery stenosis in elderly
patients. Methods Twenty-seven aged patients underwent both IFIR-FIESTA and 3D CE-MRA examinations. The imaging
quality and renal artery stenosis grades were evaluated. Kappa test was used to assess the consistency between the two
methods. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were
calculated in detecting renal artery stenosis. Results The images by the two methods were 100% qualified for diagnosis,
although the image quality of CE-MRA was significantly better. IFIR-FIESTA and CE-MRA showed excellent consistency in
detecting renal artery stenosis. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for
IFIR-FIESTA were 97.1%, 100%, 98.1%, 100%, and 95% in detecting renal artery stenosis, respectively. Conclusion IFIR-FIESTA
is feasible as a routine examination for detecting renal artery stenosis in elderly patients.