Digital subtraction angiography for evaluating patients with renal carcinoma

Intravenous digital subtraction angiography has been performed on 39 patients with renal carcinoma. In 19 patients (group 1) imaging of the renal arteries was done following injection of 40 cc intravenous contrast medium through an antecubital vein. In 20 patients (group 2) 40 cc intravenous contrast medium were injected through a femoral vein and digital subtraction imaging of the inferior vena cava was obtained. In 12 of these patients the renal arteries also were visualized from the same injection of contrast medium. Intra-arterial digital subtraction angiography of the renal arteries also was done in 5 patients in group 2. Intravenous digital subtraction angiography satisfactorily demonstrated main renal arterial anatomy in 29 of 35 patients (83 per cent) over-all but failed to delineate the renal mass in most cases. Excellent visualization of the inferior vena cava was obtained in all 20 patients in group 2. Intraarterial digital subtraction angiography yielded an accurate diagnosis of renal carcinoma in all 5 patients with minimal doses of contrast medium. We conclude that intravenous digital subtraction imaging combined with computerized tomography scanning or ultrasonography yields satisfactory diagnostic and anatomical information for most patients with renal carcinoma.