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[Multidetector CT Angiography - is it a valuable screening tool to detect significant renal artery stenosis?]
1Radiologische Klinik, Abteilung Radiologische Diagnostik, Tubingen, Germany. ulrich.hahn@med.uni-tuebingen.de
Purpose:
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.
Conclusion:
MDCTA proved to be a highly accurate tool in the detection of therapeutically relevant renal artery stenosis.