Imaging advances in the diagnosis of renovascular hypertension

Bj, Hillman

doi:10.2214/ajr.153.1.5

Cited by 59 publications

(19 citation statements)

References 24 publications

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“…Several less invasive tests (including captopril renography) have been proposed to select patients for angiography. [4][5][6][7] Magnetic resonance angiography (MRA) has shown promising results as a non-invasive imaging modality for assessing the renal arteries, but to-date fails to depict the hilar and parenchymal renal arteries. Also, CT angiography shows excellent depiction of the first segments of the renal arteries, at the expense of a relatively large amount of (nefrotoxic) contrast material and radiation.…”

Section: Introductionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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The aim of this study was to evaluate the accuracy of duplex ultrasound for the diagnosis of renovascular disease in a cohort of hypertensive patients. In 78 patients suspected of renovascular hypertension on clinical grounds duplex ultrasound examination of the renal arteries was performed. Renal angiography was used as the standard of reference. Duplex ultrasound was inconclusive in 11 kidneys (7%). None of the supernumerary renal arteries was detected with duplex ultrasound. The overall prevalence of significant renovascular disease (у50% stenosis) was 20%. Based on the combination of parameters at thresholds commonly applied in current literature: ie PSV max Ͼ180 cm/sec and RAR Ͼ3.5 the overall sensitivity of duplex ultrasound for detection of haemodynamically significant renovascular disease was 50.0% with a specificity of 91.3% (PPV: 87.9%; NPV:

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Section: Introductionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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“…CURRENTLY, THE MOST ACCURATE approach to assess the presence and severity of renal artery stenosis involves conventional x-ray angiography and selective digital subtraction angiography (DSA) (1). Stenotic lesions result in hydrostatic pressure gradients between the aorta and the glomerular afferent arterioles, which may lead to a decreased glomerular filtration rate, renal ischemia, and hypertension (2).…”

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confidence: 99%

Variations in blood flow waveforms in stenotic renal arteries by 2D phase‐contrast cine MRI

Westenberg

Wasser

Geest

et al. 1998

Magnetic Resonance Imaging

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Waveform variations in blood flow measurements through stenotic renal arteries have been reported already with echo Doppler studies. We studied these variations with MRI in 14 patients (mean age, 60 years) with suspected renal arterial stenosis (24 patent arteries, four occluded). Flow measurements were successful in 15 arteries and unsuccessful in nine, due to practical limitations. Seven healthy younger volunteers (mean age, 28 years) and five healthy older volunteers (mean age, 58 years) were recruited for comparison purposes. In patients, the severity of stenoses was also assessed by digital subtraction angiography and intraarterially measured transstenotic pressure drops. We found flow patterns to be statistically significantly (P < 0.01) age-related. Younger healthy subjects showed shorter wave duration, higher diastolic flow, and total blood flow per minute. Also, with increasing stenosis severity, the systolic wave became more damped and the systolic wave duration became statistically significantly (P = .03) longer.

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“…Fibromuscular dysplasia occurs mainly at the middle and distal renal arteries in 60-70% of the cases and frequently reaches to more distal parts like the main branches of the renal arteries. 15 RAS was at the orifice of the renal arteries in our eight patients, one of whom was in the control group. Because of this localization of RAS, especially in patient with PEX, we can consider a relationship between PEX and atherosclerosis.…”

Section: Discussionmentioning

confidence: 70%

“…This may end up with renal insufficiency. 15 In this study, aorta-renal vasculature in patients with and without PEX was examined with Doppler ultrasonography (US) and computed tomographic (CT) angiography, and the frequency of renal artery stenosis (RAS) and abdominal aorta aneurysm was evaluated.…”

Section: Introductionmentioning

confidence: 99%

Renal artery stenosis and abdominal aorta aneurysm in patients with pseudoexfoliation syndrome

Gönen

Gümüş

2013

Eye

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Purpose To evaluate the renal arteries and abdominal aorta in patients with pseudoexfoliation syndrome (PEX). Design Prospective, case-control study. Methods The study involved 49 patients with PEX and 42 control subjects. Abdominal aorta and renal arteries were examined by Doppler ultrasonography. In both renal arteries (proximal and distal portions) and abdominal aorta, the peak systolic velocity (PSV) was measured. Renal artery stenosis (RAS) was defined as the renal artery PSV 4150 cm/s or renal-to-aortic ratio (RAR) 43.0. Patients who had an abdominal aortic diameter 43 cm were recorded. Computed tomographic angiography was performed to confirm these findings in patients with RAS and/or abdominal aorta aneurysm. Results The mean PSV in the proximal renal artery was 88.3 cm/s in PEX group and 79.5 cm/s in control group (P ¼ 0.314); in distal renal artery was 91.7 cm/s in PEX group and 93.0 cm/s in control group (P ¼ 0.794); in abdominal aorta was 76.0 cm/s in PEX group and 65.2 cm/s in control group (P ¼ 0.046). RAS was observed in nine patients with PEX and in only one patient without PEX (P ¼ 0.017). Seven out of 10 patients with RAS (six patients in PEX group; one patient in control group) had hypertension. Abdominal aorta aneurysm was observed in four patients in PEX group but not in control group (P ¼ 0.061). Conclusions Our study has demonstrated that there is a significant association between PEX and RAS. The abdominal aorta aneurysm may be seen in patients with PEX.

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Imaging advances in the diagnosis of renovascular hypertension

Cited by 59 publications

References 24 publications

Renovascular disease in patients with hypertension: detection with duplex ultrasound

Renovascular disease in patients with hypertension: detection with duplex ultrasound

Variations in blood flow waveforms in stenotic renal arteries by 2D phase‐contrast cine MRI

Renal artery stenosis and abdominal aorta aneurysm in patients with pseudoexfoliation syndrome

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