HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Soulez, G. Articles by Therasse, E. Search for Related Content PubMed PubMed Citation Articles by Soulez, G. Articles by Therasse, E. Related Collections Genitourinary Radiology Related Article

Imaging of Renovascular Hypertension: Respective Values of Renal Scintigraphy, Renal Doppler US, and MR Angiography¹

¹ From the Department of Radiology, Notre-Dame Hospital, Centre Hospitalier de l'Université de Montréal, 1560 rue Sherbrooke East, Montreal, Quebec, Canada H2L 4M1 (G.S., V.L.O., V.N.); and the Departments of Nuclear Medicine (S.T., R.L.) and Radiology (E.T.), Hotel-Dieu Hospital, Centre Hospitalier de l'Université de Montréal. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received May 6, 1999; revision requested June 29; final revision received September 8; accepted September 9. Address correspondence to G.S. (e-mail: gsoulez@netcom.ca).

Renovascular hypertension affects 15%–30% of patients who have clinical criteria suggestive of renovascular disease. Noninvasive screening is crucial for patient selection prior to conventional angiography and renal revascularization. Renal scintigraphy has been reported to be sensitive for detection of renovascular hypertension, but some of its limitations (eg, in the setting of bilateral renal artery stenosis and renal failure) should be considered. Doppler ultrasonography (US) allows direct evaluation of the renal arteries as well as transrenal Doppler waveform analysis, but it remains operator dependent. Gadolinium-enhanced magnetic resonance (MR) angiography is becoming an excellent alternative to conventional angiography. The main limiting factors of this technique are inadequate visualization of segmental and accessory renal arteries as well as a tendency toward overestimation of stenoses. Given the high cost and low availability of MR angiography, scintigraphy and Doppler US should be considered the primary studies in screening for renovascular hypertension. MR angiography could be reserved for patients with inconclusive scintigraphic and Doppler US results, patients with high clinical suspicion of renovascular hypertension, and patients with a contraindication to conventional angiography.

Index Terms: Angiotensin-converting enzyme (ACE), 81.1217 • Hypertension, renovascular, 89.72 • Kidney, radionuclide studies, 81.1217 • Radionuclide imaging, comparative studies, 81.12174 • Renal arteries, MR, 961.12942 • Renal arteries, stenosis or obstruction, 961.72 • Renal arteries, US, 961.12984

Related Article

Invited Commentary • Authors' Response

Salil D. Sarkar, David N. Siegel, Gilles Soulez, and Vincent L. Oliva
RadioGraphics 2000 20: 1368-1372. [Full Text] [PDF]

This article has been cited by other articles:

				M. W. de Haan, J. M.A. van Engelshoven, A. J.H.M. Houben, D. W. Kaandorp, A. G.H. Kessels, A. A. Kroon, and P. W. de Leeuw Phase-Contrast Magnetic Resonance Flow Quantification in Renal Arteries: Comparison With 133Xenon Washout Measurements Hypertension, January 1, 2003; 41(1): 114 - 118. [Abstract] [Full Text] [PDF]

				R Williamson Multiple-choice questionnaire: general Imaging, December 1, 2002; 14(6): 488 - 497. [Full Text] [PDF]

				J. V. Behar, R. C. Nelson, J. P. Zidar, D. M. DeLong, and T. P. Smith Thin-Section Multidetector CT Angiography of Renal Artery Stents Am. J. Roentgenol., May 1, 2002; 178(5): 1155 - 1159. [Abstract] [Full Text] [PDF]