Improved identification of renal arteries in patients with aortic aneurysms by means of high-resolution computed tomography.
Suprarenal extension of abdominal aortic aneurysms (AAAs) has been reported to be present in less than 10% of patients. Its preoperative demonstration is of value in planning the aneurysm repair; however, the most appropriate radiologic method of assessment remains controversial. Although many practitioners advocate angiography, recent advances in noninvasive techniques challenge this approach. To determine the optimal method of assessment, a retrospective study of CT, ultrasonography, and angiography was undertaken in a group of 101 patients with AAA. Conventional CT was used in all patients and high-resolution CT through the region of the renal vein was used in 45 of these patients. Ultrasonography was used in 27 patients and angiography in 23. Conventional CT detected the renal artery origins in 76% of the cases--results that improved to 98% when thin-section high-resolution CT was used. These improvements in CT make the delineation of the relationship of the renal arteries to the aortic aneurysms almost as accurate as angiography at approximately half the cost. Its accuracy, safety, and cost effectiveness make CT the modality of choice in the preoperative assessment of suprarenal aortic aneurysms.
Gomes
M N
MN
Choyke
P L
PL
D000792:Angiography; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003365:Costs and Cost Analysis; D006801:Humans; D011300:Preoperative Care; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography