Diagnostic imaging of renal artery stenosis

Many different imaging modalities and techniques have been used in the past for the diagnosis of renal artery stenosis. The ideal accurate, non-invasive and inexpensive diagnostic test has yet to be found but there have been promising developments during the last few years. In this review we consider in detail the use of the following tests for the diagnosis of renal artery stenosis; intravenous urography, B Mode ultrasound, Doppler ultrasound, renal scintigraphy with angiotensin-converting enzyme inhibitors, intra-venous and intra-arterial catheter angiography, computed tomographic angiography and magnetic resonance angiography. At present intra-arterial catheter angiography remains the 'gold standard' test. Magnetic resonance angiography is currently of limited availability in the United Kingdom but is the most promising new development because it is a non-invasive test which can be used to obtain both anatomical and functional information.