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[Helical x-ray computed tomography of renal arteries. Apropos of 300 patients]
J P Beregi1, S Louvegny, L Ceugnart
1Service de Radiologie Vasculaire, Hôpital Cardiologique, CHRU de Lille.
Insights
Helical CT angiography (CTA) effectively detects renal artery stenosis in hypertensive patients, showing high sensitivity and specificity. This imaging technique is promising for diagnosing this condition.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Nephrology
Background:
- Renal artery stenosis is a significant cause of secondary hypertension.
- Accurate diagnosis is crucial for effective management and preventing complications.
Purpose of the Study:
- To assess the diagnostic performance of helical CT angiography (CTA) for detecting renal artery stenosis.
- To evaluate CTA's role in hypertensive patients.
Main Methods:
- A study involving 300 hypertensive patients.
- Helical CT angiography acquisition with specific parameters (3 mm collimation, pitch 1, 20s acquisition).
- Comparison with arteriography in a subset of patients (n=118).
Main Results:
- CTA demonstrated 100% sensitivity and 98.2% specificity for main renal artery stenoses.
- Seventy-four stenoses were identified across 300 patients.
- Secondary hypertension, including adrenal hyperplasia, was detected in 26% of patients.
Conclusions:
- Helical CT angiography is a valuable and promising tool for diagnosing renal artery stenosis.
- CTA aids in identifying the cause of secondary hypertension in hypertensive individuals.
Purpose:
To evaluate the role of helical CT angiography (CTA) in the detection of renal artery stenosis in hypertensive patients.
Materials And Methods:
We studied 300 hypertensive patients (50 prospectively and 250 consecutively) with CTA and arteriography (n = 118). Helical acquisition (collimation 3 mm; pitch = 1, 20 seconds acquisition time) was performed 20-45 seconds after contrast injection (300 mgl/ml; 120 ml, 4 ml/sec). Transverse axial views and 3D reconstructions were analyzed (360 degrees interpolation algorithm, 1 mm overlapped).
Results:
In the prospective series, CTA sensitivity was 100% for main renal artery stenoses and specificity was 98.2%; however 7/32 renal accessory arteries were not visualized. In the 300 patients studied, seventy-four stenoses were detected. There were 5 false-positive and 5 false-negative studies. Secondary hypertension was detected in 26% of patients (including 14 cases of adrenal hyperplasia).
Conclusion:
CTA is a promising technique for the detection of renal artery stenosis in hypertensive patients.