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Kidney

Renal Artery Stenosis

  • “ More recently, in a study comparing 4-slice MDCT to digital subtraction angiography, the sensitivity and specificity for all degrees of renal artery stenosis were 100% and 98.6%, respectively. For stenosis greater than 50%, sensitivity was 100% and specificity 97.3%.”
    Computed Tomography Angiography of the Renal and Mesenteric Vasculature: Concepts and Applications
    Johnson PT, Fishman EK
    Seminars in Roentgenology
    2011: 115-124
  • CT Angiography of the Renal Arteries: Fibromuscular Dysplasia
    -Causes less than 10% of cases of renal artery stenosis
    -More common in young or middle aged woman
    -Associations include smoking, hormones, and vasa vasorum disorders
    -FMD may appear as a “string of beads” appearance
    -May be bilateral in 71% of cases when symptomatic
  • CT Angiography of the Renal Arteries: Renal Artery Stenosis

    Etiology
    -Atherosclerotic disease (90%)
    -Age
    -Diabetes
    -Aortoiliac occlusive disease
    -Hypertension
    -Presence of coronary artery disease
  • CT Angiography of the Renal Arteries: Renal Artery Stenosis
    -Reconstruction of data required to define and quantify presence and degree of stenosis
    -MIP can lead to overcalling the degree of stenosis
    -VRT when used correctly has a 95-100% accuracy