Abstract: Objective To investigate the relationship between quantitative parameters of acoustic radiation force impulse (ARFI) and hemodynamics in patients with atherosclerotic renal arterial stenosis (ARAS), and to analyze their value in combined evaluation of severity of renal artery stenosis. 
Methods A total of 138 ARAS patients were selected as the observation group, and 138 healthy physical examinees were selected as the control group by 1〖DK〗∶1 principle. The shear wave velocity (SWV) of the renal cortex, renal medulla, and renal sinus, as well as the hemodynamic parameters of the renal aorta ［peak systolic velocity (PSV), end diastolic velocity (EDV), renal-aortic PSV ratio (RAR), renal-interlobar ratio (RIR)］ were recorded in two groups. Pearson analysis was used to assess the correlation between these parameters. Based on the degree of renal artery stenosis, patients were categorized into mild to moderate, and severe stenosis groups. The quantitative parameters of ARFI and hemodynamic parameters were compared among patients with different degrees of renal artery stenosis. The receiver operating characteristic (ROC) curve, area under ROC curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI) were used to evaluate the diagnostic efficiency of renal artery stenosis. 
Results ①EDV, PSV, RAR, RIR, and SWV of the renal aorta, renal cortex, renal medulla, and renal sinus in the observation group ［(40.45±8.85) m/s, (151.12±35.35) m/s, (2.38±0.66), (7.55±2.26), (3.28±0.55) m/s, (2.40±0.46) m/s, (2.31±0.41) m/s, respectively］ were higher than those in the control group ［(25.62±4.41) m/s, (114.42±34.43) m/s, (1.70±0.48), (5.24±1.58), (2.66±0.43) m/s, (1.81±0.30) m/s, (1.88±0.33) m/s (P＜0.05), respectively］. ②In ARAS patients, the SWV of the renal cortex, renal medulla, and renal sinus was positively correlated with EDV, PSV, RAR, and RIR (P＜0.05). ③The SWV of renal cortex, renal medulla, renal sinus, and the EDV, PSV, AT, RAR, and RIR of renal aorta in patients with severe renal artery stenosis were higher than those in patients with mild to moderate renal artery stenosis (P＜0.05). ④The AUC of SWV in the renal cortex, renal medulla, and renal sinus, EDV, PSV, RAR, and RIR for diagnosing the degree of renal artery stenosis was 0.813, 0.827, 0.752, 0.809, 0.802, 0.758, and 0.819, respectively. The combination of SWV and hemodynamic parameters had the highest diagnostic accuracy for NRI and IDI, with AUC of 0.688 (95%CI: 0.450-0.971) and 0.089 (95%CI: 0.030-0.115), respectively. 
Conclusion The SWV in the renal cortex, renal medulla, and renal sinus of ARAS patients shows high expression and is positively correlated with hemodynamic parameters. Combined detection is beneficial to improving the diagnostic efficiency of renal artery stenosis and guiding clinical diagnosis and treatment. 

Key words: renal artery obstruction, elastic imaging technology, hemodynamics