To explore the causes of missed diagnosis or misdiagnosis of renal artery branch abnormality with or without renal artery stenosis by ultrasound.

The ultrasound examination results for a total of 103 kidneys of 80 patients diagnosed with renal artery branch abnormalities by CT angiography (CTA) at Peking Union Medical College Hospital from January 1, 2018 to December 25, 2019 were selected for comparative analysis. The causes of missed or misdiagnosis of renal artery branch abnormalities with or without renal artery stenosis were evaluated.

Of the 103 kidneys, 27 were diagnosed with renal artery variability and stenosis and 76 were diagnosed with renal artery branch abnormalities by CTA. Of the 27 cases of renal artery variability with stenosis, 2 (7.4%) were diagnosed correctly by senior ultrasound sonographers, and 25 were inaccurately diagnosed or missed by ultrasound (15 by junior sonographers and 10 by senior sonographers). Of the 76 cases of renal artery branch abnormalities, 9 (11.8%) were correctly diagnosed by ultrasound (8 by senior sonographers and 1 by junior sonographer), and 67 were missed by ultrasound (24 by junior sonographers and 43 by senior sonographers).

The detection rate of renal artery branch variation with or without renal artery stenosis by ultrasound is low, and the ultrasound detection rate may correlate with the working experience of sonographers. This finding suggests that in the clinical practice and teaching training of sonographers, strengthening the comprehensive understanding of renal artery branch abnormalities will help improve the detection rate and ultrasound diagnosis level.