title: Renal artery stenosis: CT angiography--comparison of real-time volume-rendering and maximum intensity projection algorithms.
abstract: OBJECTIVE
  To compare results of helical computed tomographic (CT) angiography with real-time interactive volume rendering (VR) to CT angiography with maximum intensity projection (MIP) for the detection of renal artery stenosis.
  
  
  METHODS
  Twenty-five patients underwent both conventional and CT angiography of the renal arteries. Images were blindly reviewed after rendering with MIP and VR algorithms. MIP images were viewed in conjunction with axial CT images; VR models were evaluated in real time at the workstation without CT images. Findings in 50 main and 11 accessory renal arteries were categorized as normal or by degree of stenosis.
  
  
  RESULTS
  All arteries depicted on conventional angiograms were visualized on MIP and VR images. Receiver operating characteristic (ROC) analysis for MIP and VIR images demonstrated excellent discrimination for the diagnosis of stenosis of at least 50% (area under the ROC curve, 0.96-0.99). Although sensitivity was not significantly different for VR and MIP (89% vs 94%, P > .1), specificity was greater with VR (99% vs 87%, P = .008 to .08). Stenosis of at least 50% was overestimated with CT angiography in four accessory renal arteries, but three accessory renal arteries not depicted at conventional angiography were depicted at CT angiography.
  
  
  CONCLUSIONS
  In the evaluation of renal artery stenosis, CT angiography with VR is faster and more accurate than CT angiography with MIP. Accessory arteries not depicted with conventional angiography were depicted with both CT angiographic algorithms.
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: P T
authors.initials: PT
authors.lastname: Johnson
authors.forename: E J
authors.initials: EJ
authors.lastname: Halpern
authors.forename: B S
authors.initials: BS
authors.lastname: Kuszyk
authors.forename: D G
authors.initials: DG
authors.lastname: Heath
authors.forename: R J
authors.initials: RJ
authors.lastname: Wechsler
authors.forename: L N
authors.initials: LN
authors.lastname: Nazarian
authors.forename: G A
authors.initials: GA
authors.lastname: Gardiner
authors.forename: D C
authors.initials: DC
authors.lastname: Levin
authors.forename: E K
authors.initials: EK
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000792:Angiography / Q000379:methods; D003199:Computer Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed