Radiology, Vol 190, 181-189, Copyright © 1994 by Radiological Society of North America

ARTICLES

Spiral CT of renal artery stenosis: comparison of three-dimensional rendering techniques

GD Rubin, MD Dake, S Napel, RB Jeffrey Jr, CH McDonnell, FG Sommer, L Wexler and DM Williams
Department of Radiology, Stanford University Hospital and Medical Center, CA 94305-5105.

PURPOSE: To evaluate the accuracy of computed tomographic (CT) angiography in the detection of renal artery stenosis (RAS). MATERIALS AND METHODS: CT angiography was performed in 31 patients undergoing conventional renal arteriography. CT angiographic data were reconstructed with shaded surface display (SSD) and maximum-intensity projection (MIP). Stenosis was graded with a four-point scale (grades 0- 3). The presence of mural calcification, poststenotic dilatation, and nephrographic abnormalities was also noted. RESULTS: CT angiography depicted all main (n = 62) and accessory (n = 11) renal arteries that were seen at conventional arteriography. MIP CT angiography was 92% sensitive and 83% specific for the detection of grade 2-3 stenoses (> or = 70% stenosis). SSD CT angiography was 59% sensitive and 82% specific for the detection of grade 2-3 stenoses. The accuracy of stenosis grading was 80% with MIP and 55% with SSD CT angiography. Poststenotic dilatation and the presence of an abnormal nephrogram were 85% and 98% specific, respectively. CONCLUSION: CT angiography shows promise in the diagnosis of RAS. The accuracy of CT angiography varies with the three-dimensional rendering technique employed.

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