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Imaging in the evaluation of renovascular disease

Kjell Tullus1, Derek J Roebuck, Clare A McLaren

  • 1Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. TulluK@gosh.nhs.uk

Pediatric Nephrology (Berlin, Germany)
|October 27, 2009
PubMed

Insights

Renovascular disease (RVD) is a key cause of pediatric hypertension. Current imaging methods, while helpful, lack the high sensitivity needed to definitively rule out RVD in children.

Area of Science:

  • Pediatric Nephrology
  • Vascular Imaging
  • Hypertension Management

Background:

  • Renovascular disease (RVD) is a significant contributor to pediatric hypertension.
  • Early diagnosis of RVD is crucial as it is often treatable, potentially leading to a cure.

Purpose of the Study:

  • To evaluate the sensitivity of various imaging modalities for detecting renovascular disease in children.
  • To determine if current non-invasive imaging techniques can reliably exclude RVD.

Main Methods:

  • Review of imaging techniques used for diagnosing RVD in pediatric patients.
  • Comparison of the sensitivity of digital subtraction angiography (DSA), Doppler ultrasonography, CT angiography, and MR angiography.

Main Results:

  • Digital subtraction angiography remains the gold standard for RVD diagnosis.
  • Doppler ultrasonography, CT angiography, and MR angiography show potential but do not achieve sufficient sensitivity to rule out RVD.
  • No current non-invasive imaging method is sensitive enough to exclude RVD in pediatric cases with suggestive symptoms.

Conclusions:

  • High sensitivity imaging is essential for diagnosing pediatric renovascular hypertension.
  • Further advancements in imaging technology are needed to reliably exclude RVD in children.
  • Pediatric hypertension evaluation requires careful consideration of RVD, with DSA often necessary for definitive diagnosis.

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