Diagnostic Performance of the Modern Imaging Modalities in Renovascular Disease: An Evaluation
Introduction: Renal artery stenosis is a very important cause of Renovascular disease. Atherosclerosis has been identified as a most common etiology for renal artery stenosis. Long standing renal artery stenosis can cause irreversible changes in kidney hence, it is imperative to identify the di...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2016-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2159/18883_F(GH)_PF1(P_VSU)_PFA(GH)_PF2(VsuGH).pdf |
| Summary: | Introduction: Renal artery stenosis is a very important
cause of Renovascular disease. Atherosclerosis has been
identified as a most common etiology for renal artery
stenosis. Long standing renal artery stenosis can cause
irreversible changes in kidney hence, it is imperative to
identify the disease at early stage and treat.
Aim: To evaluate the diagnostic accuracy of Color
Doppler US, CT Angiography(CTA), and GD-enhanced
MR Angiography (MRA) compared with digital subtraction
angiography(DSA) for the detection of renal artery
stenosis in patients with clinically suspected renovascular
hypertension and to select the most appropriate noninvasive modality as alternate diagnostic tool compared with
the invasive intra-arterial digital subtraction angiography.
Materials and Methods: Fifty patients were prospectively
recruited from the internal medicine outpatient clinics
over the period of two years. All the hypertensive patients
between 20 and 80 years of age with an arterial systolic
blood pressure over 140 mmHg and diastolic over
90 mmHg were screened for predefined clinical clues
indicating renal artery stenosis. Patients who exhibited
at least 1 clinical clue were included in the study. All the
recruited patient further underwent Color Doppler US,
CTA and GD-enhanced MRA followed by DSA. DSA was
considered gold standard.
Results: Sensitivity, specificity, positive and negative
predictive value for diagnosis of renal artery stenosis were
75%,90%, 60% and 95%, respectively, for color Doppler
US; 90%, 93%,75%, and 97.9%, respectively, for CTA; and
90%,95%, 82%, and 98%, respectively, for GD-enhanced
MRA.
Conclusion: Diagnostic accuracy of CTA and GD enhanced
MRA is almost similar to exclude the renal artery stenosis.
Color Doppler US can be used as screening modality and
CTA or MRA to further confirm the findings or as primary
investigating modality where color Doppler US findings
were equivocal. DSA is considered gold standard hence
it can be utilized for the case with disagreement or case
where therapeutic interventions are indicated. |
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| ISSN: | 2277-8543 2455-6874 |