Intrarenal Doppler ultrasonography: which vessel should be investigated?

The aim of our study was to determine whether the site of intrarenal Doppler measurement influences diagnosis of renal artery stenosis. In an experimental test, three sheep with variable degrees of renal artery stenosis were investigated. In each animal, the resistive index from renal segmental arteries correlated better with mean pressure gradient (r = 0.85, 0.71, 0.85) and had lower standard deviation (s = 0.02 to 0.05) than resistive index from interlobar arteries (r = 0.48, 0.54, 0.61) (s = 0.03 to 0.11). In two animals the difference was significant (correlation: P < or = 0.01, P = 0.13, P < or = 0.05; standard deviation: P < or = 0.01, P < or = 0.34, P < or = 0.05). For detecting renal artery stenosis, vessels within the renal sinus should be used for Doppler sampling.