Skip to main content
SpringerLink
Log in

CTA and 2D–3D post-processing: radiological signs of fibromuscular dysplasia of renal artery

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Fibromuscular dysplasia (FMD) is one of the most common causes of renovascular hypertension in children and women. It is characterized by short multiple stenoses alternated to focal expansions that usually involve the lateral third of the renal artery. Digital subtraction angiography is considered the most accurate method in the diagnosis of renal artery FMD. An indirect sign of FMD—the notches on the ureter secondary to the hypertrophy of the branches of ureteric arteries “climbing” along the ureters—can be visualised during urography. We report the case of a 38-years-old woman with hypertension and no history of familiar predisposition, in which the multidetector computed tomography angiography was able to show both direct and indirect radiological signs of renal artery FMD. 2D and 3D visualisations are useful to suggest the diagnosis of FMD and in the follow-up in patients who underwent to percutaneous transluminal angioplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Anderson CA, Hansen KJ, Benjamin ME, Keith DR, Craven TE, Dean RH (1995) Renal artery fibromuscular dysplasia: results of current surgical therapy. J Vasc Surg 22:207–216

    Article  PubMed  CAS  Google Scholar 

  2. Beregi JP, Elkohen M, Deklunder G, Artaud D, Coullet JM, Wattinne L (1996) Helical CT angiography compared with arteriography in the detection of renal artery stenosis. AJR Am J Roentgenol 167:495–501

    PubMed  CAS  Google Scholar 

  3. Chait A, Matasar KW, Fabian CE, Mellins HZ (1971) Vascular impressions on the ureters. Am J Roentgenol Radium Ther Nucl Med 111:729–749

    PubMed  CAS  Google Scholar 

  4. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, Treatment of High Blood Pressure. National Heart, Lung, Blood Institute; National High Blood Pressure Education Program Coordinating Committee (2003) Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42:1206–1252

    Article  PubMed  CAS  Google Scholar 

  5. Cragg AH, Smith TP, Thompson BH, Maroney TP, Stanson AW, Shaw GT, Hunter DW, Cochran ST (1989) Incidental fibromuscular dysplasia in potential renal donors: long-term clinical follow-up. Radiology 172:145–147

    PubMed  CAS  Google Scholar 

  6. Daniel O, Shackman R (1952) Blood supply of human ureter in relation to ureterocolic anastomosis. Br J Urol 24:334–343

    Article  PubMed  CAS  Google Scholar 

  7. Das CJ, Neyaz Z, Thapa P, Sharma S, Vashist S (2007) Fibromuscular dysplasia of the renal arteries: a radiological review. Int Urol Nephrol 39:233–238

    Article  PubMed  Google Scholar 

  8. De Fraissinette B, Garcier JM, Dieu V, Mofid R, Ravel A, Boire JY, Boyer L (2003) Percutaneous transluminal angioplasty of dysplastic stenoses of the renal artery: results on 70 adults. Cardiovasc Intervent Radiol 26:46–51

    Article  PubMed  Google Scholar 

  9. Dyer RB, Chen MY, Zagoria RJ (2004) Classic signs in uroradiology. Radographics 24:S242–S280

    Google Scholar 

  10. Hagg A, Aberg H, Eriksson I, Lorelius LE, Morlin C (1987) Fibromuscular dysplasia of the renal artery—management and outcome. Acta Chir Scand 53:15–20

    Google Scholar 

  11. Lassiter FD (1998) The string-of-beads sign. Radiology 206:437–438

    PubMed  CAS  Google Scholar 

  12. Novick AC, Ziegelbaum M, Vidt DG, Gifford RW Jr, Pohl MA, Goormastic M (1987) Trends in surgical revascularization for renal artery disease: ten years’ experience. JAMA 257:498–501

    Article  PubMed  CAS  Google Scholar 

  13. Paven G, Waugh R, Nicholson J, Gillin A, Hennessy A (2006) Screening tests for renal artery stenosis: a case-series from an Australian tertiary referral centre. Nephrology (Carlton) 11:68–72

    Article  Google Scholar 

  14. Pennington N, Soames RW (2005) The anterior visceral branches of the abdominal aorta and their relationship to the renal arteries. Surg Radiol Anat 27:395–403

    Article  PubMed  Google Scholar 

  15. Petru B, Elena S, Dan I, Constantin D (2007) The morphology and the surgical importance of the gonadal arteries originating from the renal artery. Surg Radiol Anat 29:367–371

    Article  PubMed  Google Scholar 

  16. Pickering TG (1989) Renovascular hypertension: etiology and pathophysiology. Semin Nucl Med 19:79–88

    Article  PubMed  CAS  Google Scholar 

  17. Reiher L, Pfeiffer T, Sandmann W (2000) Longterm results after surgical reconstruction for renal artery fibromuscular dysplasia. Eur J Vasc Endovasc Surg 20:556–559

    Article  PubMed  CAS  Google Scholar 

  18. Riederer SJ, Bernstein MA, Breen JF, Busse RF, Ehman RL, Fain SB, Hulshizer TC, Iii JH, King BF, Kruger DG, Rossman PJ, Shah S (2000) Three-dimensional contrast-enhanced MR angiography with real-time fluoroscopic triggering: design specifications and technical reliability in 330 patient studies. Radiology 215:584–593

    PubMed  CAS  Google Scholar 

  19. Sabharwal R, Vladica P, Coleman P (2007) Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia. Eur J Radiol 61:520–527

    Article  PubMed  Google Scholar 

  20. Slovut DP, Olin JW (2004) Fibromuscular dysplasia. N Engl J Med 350:1862–1871

    Article  PubMed  CAS  Google Scholar 

  21. Standring S, Ellis H, Healy J, Johnson D, Williams A (2005) Gray’s Anatomy, 39th edn. Churchill Livingstone, London, p 555

    Google Scholar 

  22. Willoteaux S, Faivre-Pierret M, Moranne O, Lions C, Bruzzi J, Finot M, Gaxotte V, Mounier-Vehier C, Beregi JP (2006) Fibromuscular dysplasia of the main renal arteries: comparison of contrast-enhanced MR angiography with digital subtraction angiography. Radiology 241:922–999

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of Ferrara, Ferrara, Italy

    Alberto Clemente

  2. Department of Radiology, Euganea Medica Diagnostic Centre, Albignasego, Padova, Italy

    Alberto Clemente & Aldo Morra

  3. Department of Human Anatomy and Physiology, Section of Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy

    Veronica Macchi, Andrea Porzionato, Carla Stecco & Raffaele De Caro

Authors
  1. Alberto Clemente
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Veronica Macchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Porzionato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carla Stecco
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raffaele De Caro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aldo Morra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raffaele De Caro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Clemente, A., Macchi, V., Porzionato, A. et al. CTA and 2D–3D post-processing: radiological signs of fibromuscular dysplasia of renal artery. Surg Radiol Anat 31, 25–29 (2009). https://doi.org/10.1007/s00276-008-0384-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-008-0384-8

Keywords

Search

Navigation