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| Effect relationship between renal artery stenosis parameters and renovascular hypertension grading based on curved planar reformation technique |
| CHEN Yun, KONG Qianqian, ZHU Yan, ZHAO Tian, LI Yuefeng |
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Abstract Objective To explore the effect relationship between renal artery stenosis parameters and the grading of renovascular hypertension (RVH) by using curved planar reformation (CPR) technique. Methods The clinical and imaging data of 34 subjects specifically diagnosed with RVH were retrospectively analyzed. These patients were divided into grade 2 hypertension group (18 cases) and grade 3 hypertension group (16 cases) according to the hypertension grading standard. Another 12 subjects were enrolled as the healthy control group. The renal artery computed tomography angiography (CTA) was performed on the three groups, and the images were separately made CPR. Additionally, the morphological parameters of renal artery (the minimum pipe diameter, the minimum crosssectional area, stenosis ratio of pipe diameter and stenosis ratio of crosssectional area), and hemodynamic parameters (threshold time and bloodflow metabolic ratio) were measured. We compared the renal artery morphological and hemodynamic parameters between groups by using oneway analysis of variance. Pearson correlation analysis was used to explore the correlationship between renal artery morphological or hemodynamic parameters and blood pressure values of the subjects, while ROC curve analysis was applied to evaluate the differential diagnosis efficiency of the stenosis ratio of crosssectional area among different groups. Results Compared with the control group, the minimum pipe diameter and minimum crosssectional area of the renal artery were significantly smaller in the hypertension group, while these parameters of the grade 3 hypertension group were smaller than those of the grade 2 hypertension group (all P<0.05). Compared with the grade 2 hypertension group, the stenosis ratio of pipe diameter and stenosis ratio of crosssectional area in the grade 3 hypertension group were significantly increased (all P<0.05); the threshold time was significantly prolonged, while the bloodflow metabolic ratio significantly decreased in the grade 3 hypertension group (all P<0.05). The corrected correlation analysis revealed that the correlationship between stenosis ratio of crosssectional area and diastolic or systolic blood pressure was the most significant (r=0.663, 0.671, both P<0.01). The stenosis ratio of crosssectional area demonstrated good differential diagnosis efficiency either between the control group and the hypertension group, or between the grade 2 hypertension group and grade 3 hypertension group (AUC=0.887, P=0.014; AUC=0.818, P=0.027). Conclusion Renal artery morphological parameters (stenosis ratio of pipe diameter and stenosis ratio of crosssectional area) based on CPR technique are expected to be used as assessment and monitoring parameters for RVH.
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