Captopril-enhanced 99mTc DTPA scintigraphy in the detection of renal-artery stenosis.
The value of captopril-enhanced 99mTc DTPA scintigraphy as a screening test for renovascular disease was prospectively studied in 44 hypertensive patients suspected to have renal-artery stenosis. Renal impairment (plasma creatinine greater than 130 mumol/l) was present in 29 patients. At angiography 13 patients had unilateral stenosis, two bilateral stenosis, and 29 patients had no renovascular disease. Captopril induced a fall in split renal function in the kidney ipsilateral to the stenosis in all patients with unilateral disease (mean 52 +/- 23% to 44 +/- 21% of total renal function; P less than 0.001). A positive captopril scintigram (defined as a fall of 5% or more in split renal function) had a sensitivity of 85% and a specificity of 72% in the detection of unilateral renal-artery stenosis. Captopril-enhanced 99mTc DTPA scintigraphy is a promising non-invasive screening test for the detection of renal-artery stenosis.
Maher
E R
ER
Department of Nephrology, Royal Free Hospital, Hampstead, London, UK.
Othman
S
S
Frankel
A H
AH
Sweny
P
P
Moorhead
J F
JF
Hilson
A J
AJ
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000494:pharmacology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000097:blood / Q000000981:diagnostic imaging*; D016284:Technetium Tc 99m Pentetate
D009942:Organometallic Compounds; D004369:Pentetic Acid; D002216:Captopril; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate