The value of ultrasonography in the diagnosis of double renal arteries

doi:10.3877/cma.j.issn.1672-6448.2018.10.006

Abstract

Abstract:

Objective

To discuss the sonographic features of double renal arteries (DRAs) and assess the value of ultrasonography in the diagnosis of DRAs.

Methods

The sonographic images from 10 patients with 11 pairs of DRAs, who were diagnosed by both ultrasound and CT angiography (CTA) in Peking Union Medical College Hospital from July 2017 to June 2018, were evaluated and results were compared with those from CTA.

Results

The CTA showed that all 11 pairs of DRAs originated from the lateral wall of the abdominal aorta and supplied blood to the renal tissue through the renal portal. The location of 18 (81.8%) renal arteries was at the level of the 1st~2nd lumbar spine. The diameters of the two renal arteries in 6 pairs of DRAs were obviously different. All of the 11 pairs of DRAs and the one pair of DRAs with severe stenosis could be accurately diagnosed by sonography. The PSV values of the main and accessory renal arteries in 9 pairs of normal DRAs were (94.9±40.8) cm/s and (81.0±41.7) cm/s, and the RI values were 0.66±0.06 and 0.67±0.07, respectively. The PSV values of the corresponding interlobar arteries were (35.0±17.5) cm/s and (28.8±7.5) cm/s, and the RI values were 0.63±0.08 and 0.63±0.09 and the AT values were (0.038±0.013) s and (0.044±0.021) s, respectively. There were no statistically significant differences in PSV and RI between the main and accessory renal arteries, neither in PSV, RI and AT of the corresponding interlobar arteries between the two renal arteries (all P>0.05). The openings of 21 renal arteries could be clearly located, among which 5 pairs of DRAs had close openings (<2 cm), while another 5 pairs of DRAs had them distant openings (>2 cm). In all 11 pairs of DRAs, the display rates of renal artery openings were 95.5% on the abdominal median transverse section (21/22) and 63.6% (14/22) on the lateral coronary section, respectively. The course of all the DRAs could be seen clearly on the lateral coronary section.

Conclusions

Ultrasonography can make a definite diagnosis of the DRAs, which can provide reliable hemodynamic information. Combined with different sonographic sections, the location and course of the DRAs can be accurately evaluated.

Key words: Double renal arteries, Renal artery variation, Ultrasonography

Yahong Wang, Ying Wang, Zhitong Ge, Hongyan Wang, Binyang Gao, Jianchu Li. The value of ultrasonography in the diagnosis of double renal arteries[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(10): 758-762.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.10.006

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I10/758

Figures/Tables 3

References 15

1	彭裕文. 局部解剖学 [M]. 6版. 北京: 人民卫生出版社, 2004: 126-127.
2	洪涛，刘立刚，李建平, 等. 1057例肾动脉造影的影像解剖学分析 [J]. 中国介入心脏病学杂志, 2006, 14(3): 155-157.
3	Zhao XY, Tian J, Ru YH, et al. Application value of multislice spiral computed tomography angiography in the evaluation of renal artery variation in living donor kidney transplantation [J]. Genet Mol Res, 2015, 14(1): 314-322.
4	李鹏，石健，邵玉红, 等. 超声评价副肾动脉及其临床意义 [J]. 中国医学影像技术, 2014, 30(12): 1884-1887.
5	邢媛媛，勇强. 彩色多普勒超声诊断高血压患者副肾动脉的价值 [J]. 中国超声医学杂志, 2017, 33(9): 803-805.
6	中国医师协会超声医师分会. 血管和浅表器官超声检查指南 [M]. 北京: 人民军医出版社, 2011: 54-55.
7	吴岩，周文泉. 肾动脉变异的研究进展 [J]. 医学研究生学报, 2012, 25(11): 1225-1228.
8	聂思，彭德昌，李海军, 等. 多层螺旋CT血管成像对肾动脉解剖变异的评价 [J]. 中国医学影像学杂志, 2016, 24(10): 775-777.
9	张际青，张小东．副肾动脉定义商榷 [J]．中国临床解剖学杂志, 2010, 28(1): 109-110．
10	鲁继东，王宣传，戴正寿, 等. 国内成人副肾动脉的解剖学特征 [J]. 中国临床医学, 2013, 20(4): 512-514.
11	龙德云，陈国军，陈和平, 等. 64层螺旋CT血管成像肾动脉变异分析 [J]. 临床放射学杂志, 2010, 29(7): 929-933.
12	高小瞻，胡文法，马飞, 等. 肾动脉及副肾动脉狭窄超声诊断及漏误诊分析 [J]. 临床误诊误治, 2013, 26(3): 55-57.
13	姜玉新，冉海涛. 医学超声影像学 [M]. 2版. 北京: 人民卫生出版社, 2016: 255.
14	Aytac SK, Yigit H, Sancak T, et al. Correlation between the diameter of the main renal artery and the presence of an accessory renal artery: sonographic and angiographic evaluation [J]. J Ultrasound Med, 2003, 22(5): 433-439.
15	Ozkan U, Oguzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients [J]. Diagn Interv Radio, 2006, 12(4): 183-186.

组别	主干		相应供血叶间动脉
组别	PSV（cm/s）	RI	PSV（cm/s）	RI	AT（s）
主肾动脉	94.9±40.8	0.66±0.06	35.0±17.5	0.63±0.08	0.038±0.013
副肾动脉	81.0±41.7	0.67±0.07	28.8±7.5	0.63±0.09	0.044±0.021
t值	2.098	-1.463	1.341	0.161	-0.853
P值	0.069	0.182	0.217	0.876	0.419

组别	主干		相应供血叶间动脉
组别	PSV（cm/s）	RI	PSV（cm/s）	RI	AT（s）
主肾动脉	94.9±40.8	0.66±0.06	35.0±17.5	0.63±0.08	0.038±0.013
副肾动脉	81.0±41.7	0.67±0.07	28.8±7.5	0.63±0.09	0.044±0.021
t值	2.098	-1.463	1.341	0.161	-0.853
P值	0.069	0.182	0.217	0.876	0.419

[1]	Shujie Wei, Pinjing Hui, Yafang Ding, Bai Zhang, Yanhong Yan, Peng Zhou, Yabo Huang. Evaluation of cerebral hemodynamics in patients with unilateral internal carotid artery occlusion undergoing superficial temporal artery-middle cerebral artery bypass [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1046-1055.
[2]	Xuan Zhang, Yutong Ma, Yuqian Miao, Yun Zhang, Shiwen Wu, Xiaochu Dang, Yingying Chen, Zhaoming Zhong, Xuejuan Wang, Miao Hu, Yanfeng Sun, Xiuzhu Ma, Faqin Lyu, Haiyan Kou. Ultrasound assessment of diaphragm function in pediatric patients with Duchenne muscular dystrophy [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1068-1073.
[3]	Lianhua Zhu, Xiang Fei, Peng Han, Bo Jiang, Nan Li, Yukun Luo. Value of high frame rate contrast-enhanced ultrasound in differential diagnosis of gallbladder polyp lesions [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 904-910.
[4]	Meifang Zhang, Ying Tan, Qiaozhen Zhu, Xin Wen, Ying Yuan, Yue Qin, Hongbo Guo, Lingxiu Hou, Wenlan Huang, Guiyan Peng, Shengli Li. Artificial intelligence-based quality control of mid-sagittal plane ultrasound images for first trimester fetal crown-rump length [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 945-950.
[5]	Ruina Zhao, Yuxin Jiang, Tao Chen, Li Zhang, Cheng Chen, Siqi Jin, Xueqi Chen, Xiao Yang, Jianchu Li. Present status and reform demands of continuing medical education for ultrasonic physicians in Beijing [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 966-973.
[6]	Yuhan Zhou, Huan Xiao, Chunjiang Yang, Juan Zhou, Lirong Zhu, Juan Xu, Fangting Mou. Diagnostic value of ultrasound in children with temporary hip synovitis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 795-800.
[7]	Huanyan Liu, Yang Hua, Lingyun Jia, Xinyu Zhao, Beibei Liu. Lumen structure and hemodynamic characteristics of occluded internal carotid artery [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 809-815.
[8]	Lianlian Zhang, Pinjing Hui, Yafang Ding. Clinical value of carotid Doppler ultrasonography in assessing vulnerability of atherosclerotic plaques [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 816-821.
[9]	Yaping Jia, Shu'e Zeng. Ultrasound and pathological characteristics of breast metaplastic carcinoma containing squamous cell carcinoma components [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 844-848.
[10]	Gang Luo, Silin Pan, Taotao Chen, Qian Xu, Zhixian Ji, Sibao Wang, Lingyu Sun. Application of echocardiography in fetal cardiac intervention of pulmonary atresia with intact ventricular septum [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 605-609.
[11]	Jia Huang, Hua Shi, Yuguo Zhang, Jiaqi Hu, Qian Chen. Ultrasonographic features of normal and abnormal fetal left brachiocephalic vein and their clinical significance [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 610-617.
[12]	Ze Yuan, Li Zhuang. Value of ultrasound detection of fetal umbilical artery and middle cerebral artery blood flow in diagnosis of fetal intrauterine distress [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 618-621.
[13]	Jiachun Jiang, Xiaobing Wang, Peirong Chen, Shihao Xu. Clinical value of serological indicators combined with conventional ultrasound and contrast-enhanced ultrasound scoring in diagnosis of primary Sjögren's syndrome [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 622-630.
[14]	Mei Liao, Hongjun Zhang, Jieyang Jin, Yan Lyu, Jie Ren. Diagnostic value of bedside contrast-enhanced ultrasound for early hepatic artery thrombosis after liver transplantation [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 630-634.
[15]	Tianchi Yang, Wei Han, Feng Qiu, Jiahui Qi. Evaluation of pancreatic texture by intraoperative ultrasonic elastography [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 646-650.

Please choose a citation manager

Content to export