European Radiology

, Volume 15, Issue 11, pp 2219–2229

Contemporary imaging techniques for the diagnosis of renal artery stenosis

  • T. Leiner
  • M. W. de Haan
  • P. J. Nelemans
  • J. M. A. van Engelshoven
  • G. B. C. Vasbinder
Urogenital

Abstract

Renal artery stenosis (RAS) is a potentially curable cause of renovascular hypertension (RVH) and is caused by either atherosclerosis or fibromuscular dysplasia (FMD) in the vast majority of patients. Although intra-arterial digital subtraction angiography (IA-DSA) is still considered the standard of reference test for the anatomical diagnosis of RAS, noninvasive techniques such as MR angiography, CT angiography, and color-aided duplex ultrasonography are promising alternatives that also allow functional characterization of RAS. We provide an overview of these techniques and discuss their relative merits and shortcomings. Analysis of high-quality studies shows that both MR and CT angiography are significantly more accurate for the diagnosis of at least 50% atherosclerotic RAS than ultrasonographic techniques. The primary strength of ultrasonography at present is its suggested ability to predict functional recovery based on preinterventional resistance index measurements. A still unresolved issue is the detection of FMD. Because missing RVH may have serious consequences the most important requirement for a screening test is that it has high sensitivity.

Keywords

Renal arteries Hypertension, renal Magnetic resonance, vascular studies Computed tomography, angiography Kidney, ultrasound 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • T. Leiner
    • 1
    • 2
  • M. W. de Haan
    • 1
    • 2
  • P. J. Nelemans
    • 3
  • J. M. A. van Engelshoven
    • 1
    • 2
  • G. B. C. Vasbinder
    • 1
    • 2
  1. 1.Department of RadiologyMaastricht University HospitalMaastrichtThe Netherlands
  2. 2.Cardiovascular Research InstituteMaastrichtThe Netherlands
  3. 3.Department of EpidemiologyMaastricht University Medical SchoolMaastrichtThe Netherlands

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