Arteriographic correlation in 30 patients with renal vascular disease diagnosed with multislice CT

• Published in: Radiología Vol. 50; no. 5; p. 393
• Main Authors: Echevarría, J J, Miguélez, J L, López-Romero, S, Pastor, E, Ontoria, J M, Alustiza, J M, Fernández-Ruanova, B
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-09-2008
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Renal Artery Obstruction - diagnostic imaging; Tomography, X-Ray Computed - methods
• ISSN: 0033-8338
• DOI: 10.1016/S0033-8338(08)76054-5

To determine the usefulness of multislice computed tomography (MSCT) in the evaluation of renal vascular disease against a gold standard of digital subtraction angiography (DSA).
We evaluated 30 patients with arterial hypertension and/or kidney failure that underwent MSCT to rule out a vascular cause and DSA to confirm a vascular cause suspected at MSCT. MSCT examinations were performed on a 10-detector scanner with intravenous administration of 80 ml of iodinated contrast (300 mg iodine/ml) at a flow rate of 5 ml/s. A total of 71 renal arteries, 56 main and 15 accessory, were evaluated. Arterial stenoses were classified as: grade 0 (normal artery), grade I (stenosis < 50%), grade II (> or = 50% and < 70%), grade III (> or = 70%), grade IV (occlusion). Stenosis > or = grade II was considered hemodynamically significant.
The findings at MSCT and DSA were identical in 56 (78.8%) renal arteries; MSCT overestimated the degree of stenosis in 13 (18.3%) cases. All grade III stenoses were detected at MSCT. In the diagnosis of hemodynamically significant stenosis, MSCT had a sensitivity of 96.5%, specificity 78.5%, accuracy 85.9%, positive predictive value 75.6%, and negative predictive value 97%.
MSCT is a good noninvasive imaging technique for the evaluation of renal vessels; it is useful for screening patients with kidney disease to rule out potentially treatable vascular causes.