Vinicio Napoli MD, Presenter: Nothing to Disclose

Irene Bargellini MD, Abstract Co-Author: Nothing to Disclose

Stefania Pinto MD, Abstract Co-Author: Nothing to Disclose

Antonio Cicorelli MD, Abstract Co-Author: Nothing to Disclose

Manuela Femia, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy of the intrarenal resistivity index (RI) in predicting the outcome of renal artery percutaneous recanalization in patients with renovascular disease.

The study included 104 non diabetic, hypertensive patients who underwent renal artery percutaneous recanalization; 65 patients had significant atherosclerotic (ATH) stenosis (50 male, mean age 59 ± 10 years, serum creatinine level 1.46 ± 1.12 mg/dl), whereas 39 patients had fibrodysplasia (FDP) (35 female, mean age 42 ± 11 years, serum creatinine level 0.93 ± 0.36 mg/dl). Duplex Ultrasound (US) was perfomed in all patients, preprocedurally and every 6 months after treatment. At each examination, three consecutive measurements of the intrarenal RI were obtained bilaterally, and the mean ± SD value was calculated. Sensitivity, specificity, positive (PPV) and negative predictive (NPV) values of RI in detecting patients who will benefit from percutaneous recanalization were evaluated in relation to: type of clinical outcome (blood pressure and renal function), stenosis type (ATH and FDP), selected RI cut-off (RI < 0.65, < 0.70, < 0.80), measurement modality (ipsilateral or contralateral RI to the treated side, maximum RI). Students' t-test and stepwise multiple regression analysis were perfomed.

Using the different referral RI values < 0.65, < 0.70, and < 0.80, the preprocedural RI sensitivities were 60%, 82%, 95%, respectively (p = 0.0001) and the specificities were 62%, 42%, 13% (p = 0.0001), respectively. PPV ranged between 74% and 79%, whereas NPV ranged between 37% and 58%. In patients with atherosclerotic stenosis, RI sensitivity and specificity were 69% and 44%, respectively, while in patients with fibrodysplastic stenosis they were 89% and 33%, respectively; there was a statistically significant difference among these two groups (P<.05). RI cut-off value, measurement modality and stenosis type were parameters significantly affecting RI accuracy.

RI cut-off value, measurement modality and stenosis type might influence the accuracy of preprocedural RI in selecting non diabetic, hypertensive patients who may benefit from renal artery percutaneous treatment.

Napoli, V, Bargellini, I, Pinto, S, Cicorelli, A, Femia, M, Bartolozzi, C, Accuracy of Duplex US Intraparenchymal Resistivity Index in the Evaluation of the Outcome of Percutaneous Recanalization in Renovascular Disease.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4411952.html