Multidetector-row CT of renal arteries: review of the performances in normo- and hypertensive patients.
OBJECTIVE
To justify and illustrate the advantages of multidetector-row CT (MDCT) as probably the most effective method for imaging of renal arteries and to debate the question of multiple renal arteries.


METHODS
The renal arteries of 158 hypertensive patients were investigated with 8-row and 16-row MDCT using a highly standardized protocol; the results were compared with those obtained in a group of 112 normotensive patients.


RESULTS
MDCT of the renal arteries was found technically safely interpretable in 97.4% of cases. Fibromuscular dysplasia was found in 7/156 hypertensive patients (4.66%) concerning 9 arteries (2.18%) and > 50% atherosclerotic stenosis (in term of reduction of the cross-sectional area) was found in 11/156 patients (7%) concerning 14 arteries (3.4%). Accessory renal arteries were found in 66/156 hypertensive patients (42.3%) implicating 84 kidneys (27%) and in 50/112 patients (44.6%) of the normotensive group implicating 67 kidneys (29.9%).


CONCLUSIONS
With a good protocol, MDCT of the renal arteries is technically interpretable in most patients and can safely rule out atherosclerotic stenosis and/or fibromuscular dysplasia. The systematic cine-review of the native millimetric reconstructions and volume rendering images are the most recommended methods. Direct axial MPR views of the arterial lumen are also possible permitting a precise calculation of the percentage of stenosis from the cross-sectional area of the artery, an advantage on DSA in cases of asymmetrical stenosis. Finally a very high prevalence of multiple renal arteries--the highest ever reported to our knowledge--is found and the prevalence appears similar in both hypertensive and normotensive groups; this high prevalence not only confirms and emphasises the very high sensibility and resolution of MDCT but also definitively disproves the hypothesis that multiple renal arteries could predispose to hypertension.
Coulier
B
B
Department of Diagnostic Imaging, Clinique St Luc, Bouge, Namur, Belgium.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed