Renal artery evaluation: comparison of spiral CT angiography to intra-arterial DSA.

PURPOSE: To assess the role of spiral computed tomographic angiography (CTA) in renal artery evaluation.

MATERIALS AND METHODS: The authors prospectively performed both CTA and intraarterial digital subtraction angiography (IA-DSA) in 50 consecutive patients (24 males and 26 females) who ranged between 9 and 77 years old (mean, 39.3 years), in whom renovascular hypertension was suspected (n = 32) or who were potential renal donors (n = 18). The major scan parameters of CTA were 3-mm collimation, 4-5-mm/sec table speed, and 2-mm reconstruction interval. Both CTA and IA-DSA images were blindly interpreted by two radiologists with respect to the number of accessory renal arteries and the location and severity of renal artery stenosis.

RESULTS: CTA demonstrated 27 of 28 accessory renal arteries (detection rate = 96%). For the detection of stenoses greater than 50% (37 of 127 renal arteries, at 40 sites), the sensitivity and specificity of CTA were 90% and 97%, respectively. For the detection of stenoses greater than 50% in the main renal arteries (32 of 99 main renal arteries, at 32 sites), the sensitivity and specificity of CTA were 100% and 97%, respectively.

CONCLUSION: CTA is a reliable and accurate screening modality for the evaluation of renal arteries in patients with suspected renovascular hypertension and in potential renal donors.