title: Intravenous digital subtraction renal angiography: use in screening for renovascular hypertension.
abstract: Intravenous digital subtraction renal angiography (DSRA) has been compared with conventional angiography only in small, selected series of hypertensive patients. The authors prospectively examined with intravenous DSRA 94 patients at increased risk for renovascular hypertension and compared these studies with conventional angiography. A stenosis of at least one main renal artery was identified with intravenous DSRA in 22 patients and confirmed in 20 patients. No significant stenoses were seen with conventional angiography in any of the 64 patients in whom lesions were not seen with intravenous DSRA. Since inadequate DSRA studies were considered positive for renal artery stenosis, the sensitivity of intravenous DSRA was 100% (25 of 25); specificity, 93% (64 of 69); positive predictive value, 83% (25 of 30); and negative predictive value, 100% (64 of 64). The authors conclude that intravenous DSRA is a sensitive test for identifying stenosis of the main renal arteries and is appropriate to use as a screening test among patients at increased risk for renovascular hypertension.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC 27710.
authors.forename: N R
authors.initials: NR
authors.lastname: Dunnick
authors.forename: L P
authors.initials: LP
authors.lastname: Svetkey
authors.forename: R H
authors.initials: RH
authors.lastname: Cohan
authors.forename: G E
authors.initials: GE
authors.lastname: Newman
authors.forename: S D
authors.initials: SD
authors.lastname: Braun
authors.forename: S I
authors.initials: SI
authors.lastname: Himmelstein
authors.forename: R R
authors.initials: RR
authors.lastname: Bollinger
authors.forename: R L
authors.initials: RL
authors.lastname: McCann
authors.forename: R H
authors.initials: RH
authors.lastname: Wilkinson
authors.forename: P E
authors.initials: PE
authors.lastname: Klotman
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D013382:Subtraction Technique