title: Clinical application of computed tomographic angiography in patients with renal arterial hemorrhage: Diagnostic accuracy and subsequent therapeutic outcome.
abstract: The aim of the present study was to determine the accuracy of multi-section computed tomographic angiography (CTA) for the diagnosis of renal arterial h=emorrhage in comparison with digital subtraction angiography (DSA) and the effect of diagnostic outcome on therapeutic patient management. A retrospective analysis was conducted of the records of all patients undergoing DSA for acute renal hemorrhage between August 2005 and June 2014. A total of 74 patients were identified in whom CTA was performed prior to the DSA. DSA detected a renal arterial lesion in 68 cases and no bleeding was demonstrated in 6 cases. CTA correctly identified the bleeding site in 59 of the 68 DSA-positive cases. There were 14 patients with negative CTA results that underwent DSA after 2-10 days because of persistent hematuria, and 9 of them were found to have positive DSA results. The sensitivity, specificity, positive predictive value and negative predictive value of CTA for the detection of arterial lesions in the context of acute renal hemorrhage were 0.868, 0.833, 0.983 and 0.357, respectively. All patients with bleeding sites identified by DSA underwent superselective embolization in a single session. Five patients underwent a secondly embolization for recurrent hemorrhage. These results indicate that CTA is an accurate technique for the detection of major arterial hemorrhage and supports its use in the initial examination of these patients.
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Baishu
authors.initials: B
authors.lastname: Zhong
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Yiwei
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Chaojun
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Liang
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Fuqing
authors.initials: F
authors.lastname: Tan
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Bohua
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors.forename: Liping
authors.initials: L
authors.lastname: Xie
keywords: computed tomographic angiography; digital subtraction angiography; pseudoaneurysm; renal hemorrhage