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Renal Vascular Abnormalities

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Radiological Imaging of the Kidney

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

The application of imaging continues to play an increasing role in the evaluation of patients with suspected genitourinary disease. Cross-sectional imaging is now routine in evaluating renal vascular abnormalities in both the native and transplant kidneys. Grayscale and Doppler ultrasound have become the first-line modality for this work-up in many institutions. These modalities provide anatomic and functional information about the kidney function and vascular supply. In this chapter, normal anatomy and disease processes will be reviewed, emphasizing the various strengths and weaknesses of ultrasound, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA).

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References

  • Bax L, Woittiez AJ, Kouwenberg HJ, Mali WP, Buskens E, Beek FJ et al (2009) Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial. Ann Intern Med 150(12):840–848, W150-1

    Article  PubMed  Google Scholar 

  • Bokhari SW, Faxon DP (2004) Current advances in the diagnosis and treatment of renal artery stenosis. Rev Cardiovasc Med 5(4):204–215

    PubMed  Google Scholar 

  • Broome DR, Girguis MS, Baron PW, Cottrell AC, Kjellin I, Kirk GA (2007) Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned. AJR Am J Roentgenol 188(2):586–592

    Article  PubMed  Google Scholar 

  • Brown KG, Mohammed AJ, Kirsch TH, Chung J, Dyer JH, Ginsberg DS, Heitkamp ME, Kanne DE, Kazerooni JP, Ketai EA, Parker LH, Ravenel JA, Saleh JG, Shah AG, Steiner RD, Suh RM, RD. American College of Radiology appropriateness criteria: renovascular hypertension [cited Nov 27, 2013]. Available from: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/RenovascularHypertension.pdf

  • Buschi AJ, Harrison RB, Norman A, Brenbridge AG, Williamson BR, Gentry RR et al (1980) Distended left renal vein: CT/sonographic normal variant. AJR Am J Roentgenol 135(2):339–342

    Article  PubMed  CAS  Google Scholar 

  • Demirpolat G, Ozbek SS, Parildar M, Oran I, Memis A (2003) Reliability of intrarenal Doppler sonographic parameters of renal artery stenosis. J Clin Ultrasound 31(7):346–351

    Article  PubMed  Google Scholar 

  • Downey D (1998) The retroperitoneum and great vessels. In: Rumack C, Wilson S, Charboneau J (eds) Diagnostic ultrasound, 2nd edn. Mosby, Saint Louis, pp 453–486

    Google Scholar 

  • Dunnick NR, Hartman DS, Ford KK, Davis CJ Jr, Amis ES Jr (1983) The radiology of juxtaglomerular tumors. Radiology 147(2):321–326

    Article  PubMed  CAS  Google Scholar 

  • Garcia-Criado A, Gilabert R, Nicolau C, Real MI, Muntana X, Blasco J et al (2005) Value of Doppler sonography for predicting clinical outcome after renal artery revascularization in atherosclerotic renal artery stenosis. J Ultrasound Med 24(12):1641–1647

    PubMed  Google Scholar 

  • Harrison EG Jr, McCormack LJ (1971) Pathologic classification of renal arterial disease in renovascular hypertension. Mayo Clin Proc 46(3):161–167

    PubMed  Google Scholar 

  • Johnson PT, Halpern EJ, Kuszyk BS, Heath DG, Wechsler RJ, Nazarian LN et al (1999) Renal artery stenosis: CT angiography – comparison of real-time volume-rendering and maximum intensity projection algorithms. Radiology 211(2):337–343

    Article  PubMed  CAS  Google Scholar 

  • Karazincir S, Balci A, Gorur S, Sumbas H, Kiper AN (2007) Incidence of the retroaortic left renal vein in patients with varicocele. J Ultrasound Med 26(5):601–604

    PubMed  Google Scholar 

  • Kliewer MA, Tupler RH, Carroll BA, Paine SS, Kriegshauser JS, Hertzberg BS et al (1993) Renal artery stenosis: analysis of Doppler waveform parameters and tardus-parvus pattern. Radiology 189(3):779–787

    Article  PubMed  CAS  Google Scholar 

  • Kuczera P, Wloszczynska E, Adamczak M, Pencak P, Chudek J, Wiecek A (2009) Frequency of renal artery stenosis and variants of renal vascularization in hypertensive patients: analysis of 1550 angiographies in one centre. J Hum Hypertens 23(6):396–401

    Article  PubMed  CAS  Google Scholar 

  • Kurklinsky AK, Rooke TW (2010) Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc 85(6):552–559

    Article  PubMed  PubMed Central  Google Scholar 

  • Leder RA (1995) Genitourinary case of the day. Renal lymphangiomatosis. AJR Am J Roentgenol 165(1):197–198

    Article  PubMed  CAS  Google Scholar 

  • Llach F, Papper S, Massry SG (1980) The clinical spectrum of renal vein thrombosis: acute and chronic. Am J Med 69(6):819–827

    Article  PubMed  CAS  Google Scholar 

  • Luscher TF, Lie JT, Stanson AW, Houser OW, Hollier LH, Sheps SG (1987) Arterial fibromuscular dysplasia. Mayo Clin Proc 62(10):931–952

    Article  PubMed  CAS  Google Scholar 

  • Mulligan SA, Koslin DB, Berland LL (1992) Duplex evaluation of native renal vessels and renal allografts. Semin Ultrasound CT MR 13(1):40–52

    PubMed  CAS  Google Scholar 

  • O’Neill WC, Bardelli M, Yevzlin AS (2011) Imaging for renovascular disease. Semin Nephrol 31(3):272–282

    Article  PubMed  Google Scholar 

  • Olin JW, Piedmonte MR, Young JR, DeAnna S, Grubb M, Childs MB (1995) The utility of duplex ultrasound scanning of the renal arteries for diagnosing significant renal artery stenosis. Ann Intern Med 122(11):833–838

    Article  PubMed  CAS  Google Scholar 

  • Pellerito, JS. Renal artery stenosis. Paper presented at: Advances in Sonography; October 26, 2002. San Francisco, CA. pp 140–142.

    Google Scholar 

  • Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007) Fibromuscular dysplasia. Orphanet J Rare Dis 2:28

    Article  PubMed  PubMed Central  Google Scholar 

  • Radermacher J, Chavan A, Bleck J, Vitzthum A, Stoess B, Gebel MJ et al (2001) Use of Doppler ultrasonography to predict the outcome of therapy for renal-artery stenosis. N Engl J Med 344(6):410–417

    Article  PubMed  CAS  Google Scholar 

  • Reed MD, Friedman AC, Nealey P (1982) Anomalies of the left renal vein: analysis of 433 CT scans. J Comput Assist Tomogr 6(6):1124–1126

    Article  PubMed  CAS  Google Scholar 

  • Sheth S, Scatarige JC, Horton KM, Corl FM, Fishman EK (2001) Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector ct and three-dimensional CT. Radiographics 21(Spec No):S237–S254

    Article  PubMed  Google Scholar 

  • Stavros AT, Parker SH, Yakes WF, Chantelois AE, Burke BJ, Meyers PR et al (1992) Segmental stenosis of the renal artery: pattern recognition of tardus and parvus abnormalities with duplex sonography. Radiology 184(2):487–492

    Article  PubMed  CAS  Google Scholar 

  • Tham G, Ekelund L, Herrlin K, Lindstedt EL, Olin T, Bergentz SE (1983) Renal artery aneurysms. Natural history and prognosis. Ann Surg 197(3):348–352

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Thomsen HS (2006) Nephrogenic systemic fibrosis: a serious late adverse reaction to gadodiamide. Eur Radiol 16(12):2619–2621

    Article  PubMed  PubMed Central  Google Scholar 

  • Urban BA, Ratner LE, Fishman EK (2001) Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants, and clinical applications. Radiographics 21(2):373–386; questionnaire 549–555

    Article  PubMed  CAS  Google Scholar 

  • Vasbinder GB, Nelemans PJ, Kessels AG, Kroon AA, Maki JH, Leiner T et al (2004) Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis. Ann Intern Med 141(9):674–682; discussion 682

    Article  PubMed  Google Scholar 

  • Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C et al (2009) Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med 361(20):1953–1962

    Article  PubMed  Google Scholar 

  • Williams GJ, Macaskill P, Chan SF, Karplus TE, Yung W, Hodson EM et al (2007) Comparative accuracy of renal duplex sonographic parameters in the diagnosis of renal artery stenosis: paired and unpaired analysis. AJR Am J Roentgenol 188(3):798–811

    Article  PubMed  Google Scholar 

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Correspondence to Therese M. Weber MD .

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Weber, T.M., Lockhart, M.E. (2014). Renal Vascular Abnormalities. In: Quaia, E. (eds) Radiological Imaging of the Kidney. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54047-9_18

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  • DOI: https://doi.org/10.1007/978-3-642-54047-9_18

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54046-2

  • Online ISBN: 978-3-642-54047-9

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