目的：评估流入反转恢复稳态自由进动（IFIR-FIEASTA）序列诊断老年患者肾动脉狭窄的效能。方法对27例老年患者进行三维对比增强磁共振血管成像（3D CE-MRA）和IFIR-FIEASTA扫描，比较两种检查方法的图像质量，采用Kappa分析检验IFIR-FIEASTA和CE-MRA诊断肾动脉狭窄的一致性。以CE-MRA为金标准，评估IFIR-FIEASTA诊断肾动脉狭窄的敏感度、特异度、准确率、阳性预测值和阴性预测值。结果两种检查方法的图像质量均100%达到诊断要求，但CE-MRA的图像质量显著优于IFIR-FIEASTA。CE-MRA和IFIR-FIEASTA诊断肾动脉狭窄的一致性好；IFIR-FIEASTA诊断肾动脉狭窄的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为97.1%、100%、98.1%、100%和95%。结论IFIR-FIEASTA诊断老年患者肾动脉狭窄的可行性很高，临床实用性强。%Objective To evaluate the diagnostic efficacy of IFIR-FIESTA technique in detecting renal artery stenosis in elderly patients. Methods Twenty-seven aged patients underwent both IFIR-FIESTA and 3D CE-MRA examinations. The imaging quality and renal artery stenosis grades were evaluated. Kappa test was used to assess the consistency between the two methods. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were calculated in detecting renal artery stenosis. Results The images by the two methods were 100% qualified for diagnosis, although the image quality of CE-MRA was significantly better. IFIR-FIESTA and CE-MRA showed excellent consistency in detecting renal artery stenosis. With CE-MRA as the reference, the diagnostic sensitivity, specificity, accuracy, PPV and NPV for IFIR-FIESTA were 97.1%, 100%, 98.1%, 100%, and 95%in detecting renal artery stenosis, respectively. Conclusion IFIR-FIESTA is feasible as a routine examination for detecting renal artery stenosis in elderly patients.
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