Critical analysis of renal duplex ultrasound parameters in detecting significant renal artery stenosis.

Background Several published studies have reported differing results of renal duplex ultrasound (RDU) imaging in detecting significant renal artery stenosis (RAS) using different Doppler parameters. This study is the largest to date to compare RDU imaging vs angiography and assess various published Doppler criteria. Methods RDU imaging and angiography were both done in 313 patients (606 renal arteries). RAS was classified as normal, Results The mean PSVs and RARs for normal, P P P P = .075; EDV vs RAR, P P P = .0003), and 5.6% (34 of 606) had accessory renal arteries on angiography, with six detected on RDU imaging. The presence of accessory renal arteries, solitary kidneys, or renal fibromuscular dysplasia had no influence on overall accuracy of using PSV values for detecting ≥60% stenosis. Conclusions A PSV of 285 cm/s or an RAR of 3.7 alone can be used in detecting ≥60% RAS. Previously published data must be validated in individual vascular laboratories.