Spiral Computed Tomographic Angiography of the Renal Arteries: A Prospective Comparison with Intravenous and Intraarterial Digital Subtraction Angiography

Journal Article · Fri Mar 15 04:00:00 EST 1996 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900023· OSTI ID:21080555

Farres, Maria Teresa; Lammer, Johannes; Schima, Wolfgang ^[1]; Wagner, Brunhilde ^[2]; Wildling, Reinhard; Winkelbauer, Friedrich; Thurnher, Siegfried ^[1]

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1. Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, Vienna (Austria)
2. Department of Internal Medicine III, Division of Endocrinology and Metabolism, University of Vienna, Vienna (Austria)

Purpose: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). Methods: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation, 2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. Results: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. Conclusion: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA.

• OSTI ID: 21080555
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 19; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
ARTERIES
BIOMEDICAL RADIOGRAPHY
CONTRAST MEDIA
DIAGNOSIS
IMAGES
INTRAVENOUS INJECTION
KIDNEYS
PATIENTS
SENSITIVITY
SPECIFICITY
TIME DELAY