Nuclear medicine evaluation of hypertension

Noninvasive diagnosis of renovascular hypertension using nuclear medicine techniques has evolved in the past 30 years through improvements in imaging equipment, radiotracers, and, most recently, captopril intervention. Characteristic patterns of normal and abnormal renograms using typical radiotracers are demonstrated, including renal artery stenosis. Comparison with other tests, both invasive and noninvasive, are made with the aim toward identifying anatomic as well as physiologic definitions of renovascular hypertension. Pitfalls in the methodology are also described. The main advantage of captopril renography is enhancement of the sensitivity, and particularly the specificity, of the radionuclide diagnosis of renovascular hypertension. Available investigations have identified captopril renography as the likely procedure of choice in the noninvasive identification of renovascular hypertension.