Value of non-contrast-enhanced MR angiography combined with captopril renal scintigraphy in the diagnosis of renovascular hypertension / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the clinical value of non-contrast-enhanced MR angiography (NCE-MRA) combined with captopril renal scintigraphy (CRS) in the diagnosis of renovascular hypertension (RVH).Methods A total of 52 patients (33 males,19 females;age(54.5±16.3) years) with highly suspected RVH between January 2018 and October 2018 from Henan Provincial People's Hospital were retrospectively analyzed.The examination data of NCE-MRA,basic renal dynamic imaging,CRS and digital subtraction angiography (DSA) were collected and reviewed.The renal artery stenosis (RAS) rate ≥70％ was the criterion for RVH diagnosed by DSA,which was considered as the gold standard.The diagnostic sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of NCE-MRA,CRS and NCE-MRA+CRS were determined.The consistency between NCE-MRA and DSA was analyzed by Kappa test.The differences of diagnostic efficiencies between CRS and NCE-MRA + CRS were compared by x2 test or Fisher exact test.Results There was a high consistency between NCE-MRA and DSA in the diagnosis of RVH (Kappa=0.81,95％ CI0.62-0.96;P＜0.01).The diagnostic sensitivity,specificity,accuracy,PPV and NPV of NCE-MRA were 88.89％(24/27),92.00％(23/25),90.38％ (47/52),92.31％(24/26),and 88.46％(23/26) respectively,those of CRS were 81.48％(22/27),72.00％ (18/25),76.92％ (40/52),75.86％ (22/29) and 78.26％ (18/23) respectively,and those of NCE-MRA+CRS were 74.07％(20/27),100％(25/25),86.54％(45/52),100％(20/20) and 78.12％ (25/32) respectively.Compared with CRS,the specificity (P =0.01) and PPV (P =0.03) of NCE-MRA+CRS in the diagnosis of RVH were increased.Conclusion NCE-MRA and CRS are effective in the diagnosis of RVH,and the combination of two methods can significantly improve the diagnostic specificity and PPV than CRS alone.