Evaluation of hypertensive patients by means of captopril enhanced renal scintigraphy with technetium-99m DTPA.
One-hundred five hypertensive patients underwent conventional renal scintigraphy followed 2 or 3 days later by Captopril-enhanced renal scintigraphy, performed 1 hr after premedication with 50 mg of Captopril per os. All patients were then submitted to renal arteriography, performed within 15-30 days. Fifty-five patients had no renal artery stenosis, 29 had unilateral disease, and 21 bilateral. Overall, 34/37 patients were diagnosed by the provocative test as having at least one renal artery affected by a stenosis greater than 50%. Of those with no stenosis (n = 55) or stenosis less than 50% (n = 13) only two cases were falsely positive. Thus sensitivity was 92% and specificity 97%. For single kidney identification with stenosis greater than 50%, sensitivity of renal scintigraphy after Captopril administration was 94% and specificity 98%. Captopril enhanced renal scintigraphy is thus suggested as the first test to be performed in hypertensive patients referred for renal scintigraphic studies. Only those cases with equivocal results require a baseline study for better assessment.
Dondi
M
M
Department of Nuclear Medicine, Radiology, S. Orsola-Malpighi Policlinic Hospital, Bologna, Italy.
Franchi
R
R
Levorato
M
M
Zuccalà
A
A
Gaggi
R
R
Mirelli
M
M
Stella
A
A
Marchetta
F
F
Losinno
F
F
Monetti
N
N
D000328:Adult; D002216:Captopril; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011446:Prospective Studies; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging; D013667:Technetium; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors; D014055:Tomography, Emission-Computed / Q000379:methods
D009942:Organometallic Compounds; D013667:Technetium; D004369:Pentetic Acid; D002216:Captopril; D016284:Technetium Tc 99m Pentetate