Renal arterial stenoses: spiral CT angiography.
OBJECTIVE
To evaluate the role of spiral computed tomography (CT) in diagnosis of renal arterial stenoses.


METHODS
In 22 patients with suspected renovascular hypertension, spiral CT angiography of the renal arteries was compared with arterial digital subtraction angiography (DSA). For each patient, the peak transit time t (from intravenous injection to maximum enhancement of the abdominal aorta) was determined with a bolus injection of 15 mL of contrast medium. Spiral scanning started at the level of the superior mesenteric artery with a delay of t + 5 seconds after the start of injection of 100-150 mL of contrast medium.


RESULTS
Spiral CT angiography demonstrated multiple renal arteries in five patients. A renal artery stenosis or occlusion was found in 15 of 22 patients (22 of 54 arteries). All findings were confirmed with arterial DSA. Vessel contrast on spiral CT scans was good to excellent in 19 of 22 patients. For diagnosis, axial-section and multiplanar reformatted images were superior to three-dimensional surface reconstructions and maximum-intensity projections.


CONCLUSIONS
Spiral CT angiography is a promising screening method for renal artery stenosis.
Department of Diagnostic Radiology, Medical School Hannover, Germany.
M
M
Galanski
M
M
Prokop
A
A
Chavan
C M
CM
Schaefer
K
K
Jandeleit
J E
JE
Nischelsky
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D015901:Angiography, Digital Subtraction; D002114:Calcinosis / Q000000981:diagnostic imaging; D002933:Cineradiography; D003287:Contrast Media; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D007672:Kidney Cortex / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide