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Sonography in renovascular hypertension.
1Department of Radiology, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, California 90073, USA.
Summary
Duplex/color Doppler sonography effectively diagnoses renal artery stenosis and occlusion, correlating well with angiography. This imaging technique is crucial for monitoring post-procedure complications in patients with hypertension and renal insufficiency.
Area of Science:
- Medical Imaging
- Vascular Ultrasound
- Nephrology
Background:
- Renal artery compromise, including stenosis and occlusion, is a significant cause of secondary hypertension and renal insufficiency.
- Accurate diagnosis is essential for timely intervention and management of renovascular disease.
Purpose of the Study:
- To outline sonographic techniques for imaging renal arteries.
- To describe sonographic findings of renal artery compromise.
- To familiarize practitioners with the diagnostic utility of ultrasound in evaluating renal artery disease.
Main Methods:
- Review of approximately 1500 annual renal artery ultrasound examinations.
- Definition of optimal scanning techniques for different renal arteries and patient body types.
- Evaluation of technical success rates and diagnostic parameters, including waveform analysis.
Main Results:
- Achieved a 75%-80% technical success rate for adequate ultrasound studies.
- Direct interrogation of the renal artery proved more valuable than tardus-parvus waveform evaluation.
- Sonographic findings were correlated with contrast-enhanced angiography.
Conclusions:
- Duplex/color Doppler sonography is vital for diagnosing renal artery stenosis and occlusion.
- Ultrasound demonstrates excellent correlation with contrast-enhanced angiography.
- It is valuable for intraoperative and postrevascularization surveillance of complications like restenosis and thrombosis.