Aspirin renography in the diagnosis of renovascular hypertension: a comparative study with captopril renography.
Captopril renography is used for the non-invasive diagnosis of renovascular hypertension, but suffers from the drawbacks of lower sensitivity and false-positive tests due to a fall in blood pressure. Aspirin renography has been proposed as a useful test for evaluation of unilateral renal artery stenoses of moderate degree. We studied the clinical usefulness of aspirin renography in 12 patients with a clinical suspicion of renovascular hypertension and compared it with captopril renography using 99Tcm-DTPA. The test was considered positive if there were changes in the time-activity curve according to the criteria specified by the American Society of Hypertension Working Group. Four patients with discordant results between captopril and aspirin underwent intra-arterial digital subtraction angiography. In two patients, the renal arteries were normal; captopril was false-positive in both these patients. Bilateral stenosis was noted in the third patient, with captopril being false-negative on the right side with moderate stenosis, whereas aspirin was true-positive. There was unilateral stenosis in the fourth patient; captopril was false-positive on the contralateral side. Our results suggest that aspirin renography is superior to captopril renography in the assessment of patients with a suspicion of both unilateral and bilateral renovascular hypertension.
Maini
A
A
Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. amaini@medinst.ernet.com
Gambhir
S
S
Singhal
M
M
Kher
V
V
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D001241:Aspirin; D002216:Captopril; D002648:Child; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging; D016284:Technetium Tc 99m Pentetate
D019275:Radiopharmaceuticals; D002216:Captopril; D001241:Aspirin; D016284:Technetium Tc 99m Pentetate