Related Experiment Video
Updated: Aug 4, 2026
Use of Micro X-ray Computed Tomography with Phosphotungstic Acid Preparation to Visualize Human Fibromuscular Tissue
Published on: September 5, 2019
Fibromuscular dysplasia: what the radiologist should know: a pictorial review
L Varennes1, F Tahon, A Kastler
1Department of Neuroradiology and MRI, University Hospital of Grenoble, CS 10217-38043, Grenoble Cedex 09, France.
Unlabelled:
Fibromuscular dysplasia (FMD) is an idiopathic, segmentary, non-inflammatory and non-atherosclerotic disease that can affect all layers of both small- and medium-calibre arteries. The prevalence of FMD is estimated between 4 and 6 % in the renal arteries and between 0.3 and 3 % in the cervico-encephalic arteries. FMD most frequently affects the renal, carotid and vertebral arteries, but it can theoretically affect any artery. Radiologists play an important role in the diagnosis of FMD, and good knowledge of FMD's signs will certainly help reduce the delay between the first symptoms and diagnosis. The common string-of-beads aspect is well known, but less common presentations also have to be considered. These less common imaging findings include vascular loops, fusiform vascular ectasia, arterial dissection, aneurysm and subarachnoid haemorrhage. These radiologic presentations should be known by radiologists in order to diagnose possible FMD, particularly when present in young females or when associated with personal or familial hypertension, to reduce the delay between the onset of the first symptom and the final diagnosis. The patients have to be referred to specialised FMD centres for dedicated management.
Teaching Points:
• Fibromuscular dysplasia is not a rare disease. • Radiologists should recognise less common presentations to orient specific management. • Vascular loops, fusiform vascular ectasia and a "string-of-beads" aspect are typical presentations. • Arterial dissection, aneurysm and subarachnoid haemorrhage are less typical radiologic presentations.
Insights
Fibromuscular dysplasia (FMD) is a non-atherosclerotic arterial disease affecting small- and medium-calibre arteries. Recognizing both typical and less common imaging findings is crucial for timely diagnosis and management of FMD.
Area of Science:
- Vascular Medicine
- Radiology
- Arterial Diseases
Background:
- Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory condition affecting artery walls.
- It commonly impacts renal, carotid, and vertebral arteries, with estimated prevalences of 4-6% in renal arteries and 0.3-3% in cervico-cephalic arteries.
- FMD can affect any artery, impacting both small and medium-calibre vessels.
Purpose of the Study:
- To highlight the importance of radiologists in diagnosing FMD.
- To emphasize the need for recognizing both common and less common imaging presentations of FMD.
- To reduce the diagnostic delay for patients with FMD.
Main Methods:
- Review of imaging findings associated with FMD.
- Discussion of typical and atypical radiological presentations.
- Emphasis on the role of radiologists in early detection.
Main Results:
- The 'string-of-beads' appearance is a well-known sign of FMD.
- Less common but significant findings include vascular loops, fusiform ectasia, arterial dissection, aneurysm, and subarachnoid hemorrhage.
- Early recognition of these signs, especially in young females or those with hypertension, is key.
Conclusions:
- Fibromuscular dysplasia is a significant arterial disease that is not rare.
- Radiologists must be aware of diverse FMD presentations, including less common ones, to guide appropriate patient management.
- Prompt diagnosis through recognizing characteristic imaging findings like "string-of-beads", vascular loops, and ectasia, as well as less typical signs, is vital.
Related Concept Videos
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called a...
01:30Radiological Investigation I: X-ray and CT
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...