Medline ® Abstract for Reference 14

OBJECTIVE: To determine the usefulness of multislice computed tomography (MSCT) in the evaluation of renal vascular disease against a gold standard of digital subtraction angiography (DSA).

MATERIAL AND METHODS: We evaluated 30 patients with arterial hypertension and/or kidney failure that underwent MSCT to rule out a vascular cause and DSA to confirm a vascular cause suspected at MSCT. MSCT examinations were performed on a 10-detector scanner with intravenous administration of 80 ml of iodinated contrast (300 mg iodine/ml) at a flow rate of 5 ml/s. A total of 71 renal arteries, 56 main and 15 accessory, were evaluated. Arterial stenoses were classified as: grade 0 (normal artery), grade I (stenosis<50%), grade II (>or = 50% and<70%), grade III (>or = 70%), grade IV (occlusion). Stenosis>or = grade II was considered hemodynamically significant.

RESULTS: The findings at MSCT and DSA were identical in 56 (78.8%) renal arteries; MSCT overestimated the degree of stenosis in 13 (18.3%) cases.All grade III stenoses were detected at MSCT. In the diagnosis of hemodynamically significant stenosis, MSCT had a sensitivity of 96.5%, specificity 78.5%, accuracy 85.9%, positive predictive value 75.6%, and negative predictive value 97%.

CONCLUSIONS: MSCT is a good noninvasive imaging technique for the evaluation of renal vessels; it is useful for screening patients with kidney disease to rule out potentially treatable vascular causes.