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[CO2 angiography of transplanted kidneys]
Heike Lorch1, Jürgen Steinhoff, Lutz Fricke
1Institut für Radiologie, Universitätsklinikum Lübeck, Lübeck. lorch@medinf.mu-luebeck.de
Rontgenpraxis; Zeitschrift Fur Radiologische Technik
|March 26, 2003
Summary
Carbon dioxide (CO2) angiography is a feasible option for evaluating renal transplant arteries, offering a 100% positive predictive value. While image quality is lower than iodinated contrast medium, it reduces the need for contrast agents and does not compromise renal function.
Area of Science:
- Nephrology
- Radiology
- Vascular Surgery
Background:
- Renal transplant artery stenosis is a significant complication affecting graft survival.
- Iodinated contrast media (CM) carry risks, especially in patients with compromised renal function.
- Digital subtraction angiography (DSA) is a key imaging modality for evaluating renal arteries.
Purpose of the Study:
- To compare the image quality and diagnostic accuracy of carbon dioxide (CO2) and iodinated CM in renal transplant artery angiography.
- To assess the feasibility and practicality of using CO2 as a primary contrast agent.
Main Methods:
- A prospective, non-randomized, intra-individual study involving 17 patients.
- Digital subtraction angiography (DSA) performed first with CO2 for optimal projection, followed by a confirming run with CM.
- Comparison of image quality, diagnostic accuracy, and monitoring of creatinine levels post-procedure.
Main Results:
- CO2 correctly diagnosed three out of four renal transplant artery stenoses.
- CO2 angiography demonstrated a 100% positive predictive value, with no false-positive results.
- Image quality with CO2 was inferior to CM, but renal function was not compromised.
Conclusions:
- CO2 is a feasible and practical contrast agent for initial angiographic evaluation of renal transplant arteries.
- Using CO2 can reduce the overall amount of CM required.
- Confirmation with CM remains necessary for definitive diagnosis.