[Multidetector CT Angiography - is it a valuable screening tool to detect significant renal artery stenosis?].
OBJECTIVE
To evaluate the diagnostic value of multidetector CT angiography (MDCTA) of the renal arteries.


METHODS
27 patients underwent MDCTA of the renal arteries. Scan parameters were: collimation 4 x 1 mm, pitch 1.5, effective slice thickness 1.25 mm, reconstruction increment 0.8 mm, circulation time measurement, power injection of 80 ml iomeprol 400, flow 4 ml/sec. Independent reading on laser film was done by two radiologists using edited maximum intensity projections, multiplanar reconstructions and source images. Standard of reference was a 3D-FLASH MR angiography (1.5 T, 3.9/1.2, 10 degrees 0.2 mmol GdDTPA/kg bw) in 10 and intraarterial angiography in 17 patients.


RESULTS
Analysing 63 arteries, sensitivity, specificity, positive predictive value and negative predictive value in terms of detection of moderate and high grade renal artery stenosis (n = 10) were 90, 98, 90 and 98 % for reader A, and 90 % each for reader B, respectively (kappa = 0.91 interobserver agreement). 1/11 accessory renal arteries was missed by both angiography and MDCTA. Image quality was graded as excellent or good in 26/27 of cases by both readers.


CONCLUSIONS
MDCTA proved to be a highly accurate tool in the detection of therapeutically relevant renal artery stenosis.
Hahn
U
U
Radiologische Klinik, Abteilung Radiologische Diagnostik, Tubingen, Germany. ulrich.hahn@med.uni-tuebingen.de
König
C W
CW
Miller
S
S
Brehm
B
B
Heuschmid
M
M
Kopp
A F
AF
Claussen
C D
CD
D000368:Aged; D000792:Angiography; D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007479:Iopamidol / Q000031:analogs & derivatives*; D018810:Magnetic Resonance Angiography; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol